Keloid scars are a common concern for those considering a tummy tuck procedure. These abnormal scars can occur due to the body’s excessive response to skin injuries, including surgical incisions. This article will provide an in-depth look at keloid scars, the tummy tuck procedure, and how to manage and treat keloid scars following a tummy tuck.
What are Keloid Scars?
Keloid scars, often referred to as pathologic scars, are overgrown scar tissue extending beyond the original wound site, making them a concern for patients wishing to undergo procedures like a tummy tuck. These abnormal scars are characterized by their raised, thick, and irregular appearance, often appearing shiny and darker than the surrounding skin, which can be particularly noticeable on darker skin tones.
Unlike hypertrophic scars, another type of raised scar that stays within the original wound’s boundaries, keloid scars extend beyond these boundaries, creating a more prominent, more visible scar.
Keloid scars result from an overproduction of collagen during the wound-healing process, leading to an excess of collagen fibers in the scar tissue. This excess collagen production increases the size and thickness of the scar, leading to the characteristic bumpy or cauliflower-like appearance of keloid scars.
While keloid scars can develop anywhere on the body, they are more frequently observed in areas with minimal fatty tissue, such as the chest, back, and earlobes. However, they can also form at the site of surgical incisions, such as those made during a tummy tuck procedure.
Understanding the Tummy Tuck Procedure
Abdominoplasty (tummy tuck) is a well-known plastic surgery procedure that can enhance body contour by removing excess fat and skin from the abdominal region while also tightening the underlying abdominal muscles. Many patients who have undergone significant weight loss or pregnancy seek this procedure as it can help address loose skin and weakened abdominal muscles.
The tummy tuck procedure begins with the surgeon making a surgical incision, typically a horizontal incision, between the pubic bone and the belly button. In some cases, additional incisions may be required, such as a circular incision around the belly button or a vertical incision, depending on the extent of the excess skin and the patient’s body shape. After making an incision, the surgeon lifts the skin of the abdomen to reveal the underlying muscles. These muscles are tightened and stitched together to create a fitter shape and a firmer abdominal wall.
Despite the many benefits, like improved body shape and a fit appearance, a tummy tuck procedure does carry potential risks, including the formation of keloid scars.
Keloid Scars After a Tummy Tuck
The formation of keloid scars after a tummy tuck is particularly prevalent in individuals with a genetic component or predisposition to keloid formation. When the body heals from the surgical incisions made during a tummy tuck, it produces collagen fibers to repair the wound. In some individuals, collagen production increases excessively, leading to the formation of a keloid scar.
Factors That May Increase the Risk of Keloid Formation
Certain factors can increase the risk of keloid formation following tummy tuck surgery. This adverse scar condition can be more common in darker skin types due to the development of skin discoloration. Those with a family history of keloids and being of a particular age group (10-30 years old) are also at risk.
Other factors, such as tension on the wound edges, infection, and poor wound care, can also contribute to keloid formation.
How to Identify Keloid Scars
Keloid scars are typically characterized by their raised, thick, and irregular appearance, often appearing shiny and darker than the surrounding skin. These scars can be pink, red, or darker than the surrounding skin.
Unlike hypertrophic scars, which stay within the boundaries of the original wound, keloid scars extend beyond these boundaries. They may also continue to grow and may not regress over time.
Managing and Treating Keloid Scars
Although keloid scars can be challenging to treat, several strategies can help manage and treat these scars.
Prevention Strategies Before and During the Tummy Tuck Procedure
Prevention indeed plays a pivotal role when it comes to managing keloid scars, especially in the context of a tummy tuck procedure.
One such strategy involves the use of meticulous surgical techniques. The surgeon, ideally a board-certified plastic surgeon with expertise in body contouring procedures, can minimize excessive tension on the wound edges, a factor that can contribute to abnormal scarring.
This can be achieved through careful scar placement and closure techniques, including deep wound closure techniques that distribute tension across the deeper layer of the abdominal wall rather than the skin surface.
Postoperative Care to Minimize Keloid Scar Development
Postoperative wound care is crucial in preventing keloid scar development.
This includes keeping the incision clean and dry. Proper care is crucial in reducing the risk of bacterial infections, which can complicate the healing process and potentially lead to poor scarring. This may involve gently washing the area with mild soap and water, patting it dry, and applying a prescribed ointment.
Avoiding sun exposure and adhering to aftercare instructions provided by the surgeon are also advised.
Treatment Options for Existing Keloid Scars After a Tummy Tuck
Treatment options for existing keloid scars include silicone gel (sheeting), corticosteroid injections, and laser therapy. In some cases, surgical revision may be necessary.
Non-Surgical Treatments for Keloid Scars
Non-surgical treatments are frequently successful in managing keloid scars, a common concern for patients wishing to undergo a tummy tuck procedure. Among these treatments, plastic surgeons often recommend silicone gels and sheets due to their proven efficacy in scar care. These topical treatments have the ability to flatten and soften keloids.
Corticosteroid injections are another non-surgical treatment option. Injecting this steroid directly into the keloid scar can help reduce inflammation and slow down excess collagen production, leading to a flatter and softer scar. Typically, injections are administered every four to eight weeks until the desired result is achieved.
Laser therapy, particularly pulsed dye lasers, can also reduce the redness and size of keloid scars. This treatment targets blood vessels in the scar tissue, reducing redness and triggering the body’s natural healing process.
Surgical Options for Keloid Scar Revision
In some cases, keloid removal may be necessary to treat these scars. This procedure involves removing the keloid scar and carefully closing the wound to minimize the risk of keloid recurrence. It’s important to note that surgical revision should be combined with other treatments, such as corticosteroid injections or silicone sheets.
Importance of a Consultation with a Plastic Surgeon
Understanding the risk of keloid scars after a tummy tuck is essential in making an informed decision about undergoing the procedure. Taking preventative measures and following postoperative care instructions can minimize the risk of keloid formation.
A consultation with a double board-certified plastic surgeon, such as Dr. Gabriel Salloum at the Miami Center for Plastic Surgery, is essential for anyone considering a tummy tuck procedure. He can assess your risk of developing keloid scars, discuss prevention strategies, and provide information on treatment options should keloids form. Contact us today by filling out an online form or calling 305-405-6910.