All surgery leaves scars; it’s an inevitable part of the process, but one that is hopefully offset by the surgery’s outcomes. This article explains where scars are usually placed for the various Body Contouring procedures. It also discusses the steps we take (and what you can do) to minimise the appearance of your scars in the long term.
Body Contouring surgery addresses the complex needs of individuals who have experienced massive weight loss. It can comprise many surgical procedures, each tailored to the individual. Over the years, Dr Dona has continued to refine and develop his techniques to address the varied and complex needs of post-weight-loss patients. In doing so, he’s defined ‘The 7 ‘B’s of Body Contouring Surgery.
The procedures listed below include their typical scars. However, they serve only as a guide. Every surgery is tailored to the individual, and scar patterns can vary from person to person.
BRACHIOPLASTY (ARM LIFT) – Removes excessive loose skin along the upper arm.
Brachioplasty Scar: Typically extends along the inner or posterior (rear) aspect of the upper arm towards the armpit, with the exact length depending on the amount of excess skin.
BREAST SURGERY – Breast Reductions, Breast Lifts or Breast Augmentations.
- Breast Lift/Reduction Scar: For traditional anchor-shaped Breast Lift or Reduction incisions, there is a scar hidden in the breast crease, another that runs vertically to the areola and a circumferential scar around the areola.
- Breast Augmentation Scar: Typically, a horizontal (inframammary) scar hidden in the breast crease. Alternatively, (and less often), there may be a small scar in the armpit or around the areola.
BRA LIPECTOMY – A Bra Lipectomy removes skin and tissues in the upper middle of the back around the bra strap area (bra rolls). This procedure is also called an Upper Body Lift, a Bra Line Back Lift or an Upper Truncoplasty.
Bra Lipectomy Scar: Across the back, similar to that of a bra strap.
BELLY SURGERY (ABDOMINOPLASTY, A.K.A. TUMMY TUCK SURGERY) – The type of Abdominoplasty Surgery required will be determined by the amount of excess skin and fat in the middle and lower abdominal wall.
- Standard Abdominoplasty Scar: A horizontal scar running from hip to hip and is generally hidden under most underwear. There is also a small circumferential scar around the navel.
- Fleur-De-Lis Abdominoplasty Scar: In addition to the standard Abdominoplasty scars, there is a vertical scar running up the entire midline of the abdomen.
- Open Book Tummy Tuck™ (Abdominoplasty) Scar: In addition to the Fleur-De-Lis Abdominoplasty Scar, there is a horizontal scar that hides in the breast fold.
BELT LIPECTOMY – Removes excess fat and skin circumferentially, around the lower back, sides of waist and abdomen. It is effectively two combined operations – an Abdominoplasty and a Buttock Lift. It goes by several names, including 360 Tummy Tuck, Lower Body Lift, Total Body Lift and Lower Truncoplasty.
Belt Lipectomy Scar: A circumferential scar around the belt line.
BUTTOCK LIFT – Lifts and tightens the buttocks, removing excess skin from the lower back and creating a far more comfortable form along your back and buttocks.
Buttock Lift Scar: Runs along the upper buttock, along the sides, and extending a variable distance along the lower abdominal wall.
BELOW THE WAISTLINE SURGERY – Tightening and altering the form of the inner thigh by removing excess skin and fatty tissue. This can also refer to surgery involving the mons pubis and genital region (e.g., Labiaplasty).
Mons Pubis Scar: A horizontal incision (7 – 15 cm) above the pubic bone.
Inner Thigh Scars: Vary, depending on the procedure performed.
Labiaplasty Scars: Typically small, discreet and difficult to see.
What Is a Scar?
A scar is a collection of fibrous tissue that replaces normal skin after injury. It is a natural part of the healing process. Scars contain the same protein (collagen) as your skin, but their protein composition is different.
Normal skin has a random basket-weave arrangement of collagen fibres. However, scar tissue forms a pronounced alignment of collagen fibres in a single direction. Scar formation varies depending on factors such as your skin type, overall health, age, nutrition and the type and location of the scar.
The Scar Healing Process Explained
Immediately after your Body Contouring surgery, your body begins the healing process. This process has four stages:
Homeostasis: This is the body’s immediate response to injury that stops bleeding. Blood vessels constrict, platelets become activated, and they accumulate at the wound site to help form a clot.
Inflammation: This brings white blood cells to the location to help you heal. These cells, called neutrophils and macrophages, help remove bacteria and other substances that can cause an infection. Additionally, they prepare the body to build new tissue and repair the wound.
The inflammatory phase begins soon after injury and usually lasts several days, although some aspects of inflammation can continue longer. Swelling and inflammation are normal parts of the early healing process and gradually settle over time.
At this stage, macrophages signal another cell type to begin the next phase of healing.
Proliferation: Fibroblasts produce collagen and other extracellular matrix components, while new tissue and blood vessels develop to help rebuild the wound. This phase begins within days of the injury and continues for several weeks.
Remodelling: This final phase can continue for many months and, in some cases, for a year or longer. During this time, collagen gradually reorganises, and the scar typically becomes softer, flatter and paler.
How Will Your Scars Look During Healing?
At first, your scars will be raised, red or purple and highly visible. The area around the scars may look red, puffy and swollen. During the early weeks and months, they will remain bright red, pink or purple and may feel firm or tight. They gradually soften and become paler as remodelling continues.
How to Optimise Healing & Minimise the Appearance of Scars
There are various things you can do to optimise healing and minimise the appearance of your scars. You should also avoid several things that can worsen a scar’s appearance.
At Bella Plastic Surgery, all Body Contouring surgery patients follow an intensive post-surgical care plan. This includes not only assessing your wounds and monitoring your progress, but also our heaLED post-surgical care plan. This plan includes several advanced treatments and therapies that help accelerate repair, reduce swelling, and minimise scarring.
You’ll have weekly sessions starting the day you leave hospital or the day after. These treatments include:
LED Light Therapy: A scientifically proven treatment that is a non-invasive and effective way to accelerate the healing process for scars. It uses LED lights at specific wavelengths to deliver concentrated energy into your tissues. It can help rejuvenate the skin by stimulating blood flow and supporting the skin’s ability to heal.
When treating scars, LED Light Therapy has been shown to accelerate tissue repair, reduce wound size and promote wound closure. It also minimises pain and inflammation and accelerates healing. However, outcomes vary by individual.
Patients typically receive two to three sessions a week for at least the first few weeks.
Rejuran Therapy: This treatment contains polynucleotides (PN), which are purified DNA-derived molecules from salmon. Polynucleotides have been investigated for their potential effects on tissue repair, fibroblast activity and skin quality. Dr Dona may recommend this treatment as part of an individualised post-operative care plan.
Microneedling (Dry Skin Needling): This minimally invasive procedure can help to reduce the visibility of post-surgical scars. Using a handheld device, fine needles create tiny microchannels in the scar tissue, creating micro-injuries. This activates the body’s healing response, stimulating collagen and elastin production. Microneedling may help alter the texture and appearance of some mature scars. Patients typically have three treatments spaced over a three- or four-month period.
Medical-Grade Skincare: You’ll be given medical-grade skincare to help minimise the appearance of your scars. These include Gernetic Synchro cream to help optimise scar formation, and Cytobi for added cellular repair and resilience.
Positive Lifestyle Factors to Help Minimise Scarring
Scar healing takes significant time. During this time, you should do your best to stay as healthy as possible. Here are some of the things you can do.
Optimise your health and nutrition: Eating a balanced, nutrient-rich diet provides your body with the protein, vitamins, minerals and energy it needs for healing. Include a variety of fruit and vegetables, lean sources of protein, whole grains and other nutrient-dense foods to support your recovery.
Avoid or minimise alcohol consumption: Alcohol can contribute to dehydration and may interfere with your recovery. It can also interact with certain medications, so it is important to avoid alcohol around the time of your surgery and while taking medications that may interact with it.
Stay hydrated: Good hydration supports normal body functions and supports healing. Aim to drink fluids regularly throughout the day.
Prioritise sleep: Your body needs adequate rest during recovery. Aim for good-quality sleep and allow yourself plenty of rest, particularly during the early stages of healing.
Protect your scars from the sun: New scars are particularly sensitive to ultraviolet (UV) exposure. Sun exposure can cause scars to darken and become more noticeable. Keep your scars covered with clothing where possible and, once your incisions have healed enough to use sunscreen, apply a broad-spectrum SPF 50+ sunscreen as directed by our clinical team.
Abnormal Scar Formation
Abnormal scar formation is uncommon in most surgical procedures, though some procedures, and some individuals, carry a greater risk of scarring than others. Several factors come into play, such as your skin colour, genetics, and age, as well as wound location or any healing complications that may occur.
While abnormal scar formation is rare, it’s good to know what can happen. Keep in mind, though, that after your surgery, our nursing team will regularly treat your incisions to optimise healing and reduce the risk of poor scarring.
Keloid scar: A raised, thick scar that grows beyond the original incision mark, caused by excessive collagen production.
Hypertrophic scar: A raised, thick scar that develops from an abnormal wound healing response where too much collagen is produced. Hypertrophic scars remain within the boundaries of the original wound. They are often pink or red.
Tethered scar: This scar can form when fibrous tissue pulls the top layer of skin down, anchoring it to deeper tissues. This creates a depression in the skin surface, resulting in an uneven or dimpled appearance.
Widened scars: Also called stretched scars, these often result from a wound under tension. Tension across a healing wound can make a scar wider than the original incision.
Book a Consultation with Dr Dona
If you’d like to learn more about Body Contouring surgery and the scars that can result with Dr Eddy Dona, the first step is to book an appointment with him in his Sydney-based rooms.
During your consultation, you can discuss your objectives, have Dr Dona thoroughly examine your body and review your medical history.
If he determines that Body Contouring surgery may be considered, he will explain the options, the surgical approach and the scars involved. He will also outline the expected recovery, all costs, potential risks and complications and answer any questions you have so that you feel fully informed and able to decide on surgery.
