Tummy tuck scars

17th May 2017

It is very interesting to listen to patients coming from other surgeons who are unhappy with the appearance of their scars. With any plastic surgery, you will need to accept a scar. The length of the scar will be determined by the amount of excess skin that you have. The scar tends to heal over time. Typically at the beginning of the healing process the scar is very red, and subsequently it tends to fade away, but you are always going to have a scar. There are many things that can happen with the scar after surgery: for example, your scar can get thick, your scar can get wide, or your scar can get discolored. The impression of patients is that if somebody has a good scar, their surgeon was more competent than one who operated on somebody who developed a bad scar. In other words, bad scar, bad surgeon.

Think about what you are saying. Let’s say that I am closing a tummy tuck incision and I close it the best way I can, I do not have magic hands or superpowers to make your scar heal better. The healing of the scar depends on your genetics and how well you heal. The two things the surgeon can control are that the scar is symmetric and not inverted, meaning that when the scar heals it does not go in. Those are the only two things that we can control with surgery.

On this diagram, I am going to show you the surgeon’s perspective of a good scar in terms of closure. When the scar is closed, it should be everted; that means that during the first couple of months, your scar should be raised slightly. This will help to prevent an aesthetically unpleasant scar. A scar that was not sutured properly will be inverted: in other words, the edges of the scar will go in. Whenever you have a scar or any cosmetic surgery, you need to understand that the way you heal is the way you heal. The surgeons are physicians, not magicians. They can’t control how you heal, although certain things can be done to minimize scar formation, such as Kenalog injections, silicon dressings, compression of the scar, massage of the scar, etc.

Next time you see a bad scar, think about what you are saying. Just because you have a scar that is red, that does not mean the surgeon is bad. Just because you have a scar that got wide, that does not mean the surgeon is a bad surgeon. If you developed a keloid, that does not mean that the surgeon had any control over it. Ultimately, how you heal is how you heal, and you need to accept this prior to surgery; if not, you’re just going to blame the surgeon for the healing process that only God can control.

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