Scar Tactics
Don’t Be Too Scarred from Your Mommy Makeover
It is normal to have fears about scarring, particularly with a tummy tuck and breast surgery for a mommy makeover. Plastic surgeons use a variety of strategies to minimize scars, but it is not possible (yet) to do surgery without leaving a scar. Normal healing involves the formation of a scar, and with a mommy makeover, the trade-off is well worth it.
These images were taken 1 month and 6 months post-procedure. The patient underwent a post-mommy makeover including a Galaflex internal bra.
Understanding The Tradeoff
One trade-off is contour vs. length of the scar. For example, patients often request a mini tummy tuck because the scar is shorter, but for most the longer scar will give a better overall result. If the scar is placed low, it will be in a concealable location with either type of tummy tuck. The same applies for breast lifts; if the shape will be better with a full lift vs. a circumvertical lift (lollipop scar) or a periareolar (Benelli), then go for it.
Although the visible scar is on the surface, a lot depends on what the surgeon does underneath. Tummy tucks are a great example of this. Using the progressive tension suture technique (PTS), the tightness is distributed along a deep layer called the fascia, so there is minimal tension on the skin. Reducing tension on the skin edges makes for a better scar. With breast lifts, the internal bra is a similar concept. By using Galaflex mesh to support the breast, the skin envelope can be reshaped with less tension.
Long-term Diligence Pays Off
Postoperative management makes a difference too. My routine is taping for up to 6 weeks. This minimizes the forces of pulling and stretching along the scar as it begins to form. This allows the healing process to get off to a good start.
Afterward, there are a variety of products available that can be helpful. Most of the evidence indicates that silicone tapes can make a difference. What is very important to keep in mind is that scars go through different phases of healing, and improve in appearance for a year or more. For that reason, many “before and after” photos of scar treatments are misleading, because they don’t show a comparison to an untreated section of the scar. You don’t really know what degree of improvement could have been achieved without treatment.
These images were taken 1 month and 6 months post-tummy tuck procedure.
What Can You Do Moving Forward?
One thing that doesn’t work is vitamin E; several well-controlled studies show that scars fade and improve just as well without it. For scars that are not fading as desired, options include pulsed light therapy (IPL) and steroid injections. IPL works best on scars that are red, and several sessions may be required. Steroid injections work best on thick scars, but can result in widening of the scar. In the future, almost scar-free healing may be possible, with some products already in clinical trials. For now, most patients can get an acceptable scar appearance with good management.
