How to Manage and Minimise Scarring after An Abdominoplasty

Scarring is an integral part of surgery and a crucial part of the body’s healing process. However, if you’re considering an Abdominoplasty,  it’s natural to be concerned about them. An Abdominoplasty scar sits below the underwear line, and although it won’t disappear, it will typically fade over time. Importantly, though, there are things you can do to help it heal well and help minimise its appearance.

What Scars Will I Have Following an Abdominoplasty?

There are many different types of Abdominoplasty procedures, with some being more invasive (leaving larger scars) than others. Here is a quick rundown of the most common types of procedures and their associated scars.

• Mini Tummy Tuck (Abdominoplasty): Has a short horizontal scar situated low on the abdomen (concealed under most underwear), slightly longer than a C-section scar
• Standard Tummy Tuck (Abdominoplasty): Has a long horizontal scar situated low on the abdomen, running from hip to hip (concealed under most underwear), along with a small comfort radial scar around the belly button.
• Fleur De Lis Tummy Tuck (Abdominoplasty): In addition to the scars of a standard abdominoplasty, it has a midline vertical incision running from the lower abdomen towards the chest.
• OPEN BOOK TUMMY TUCK™ (Abdominoplasty): In addition to the scars of the Fleur-De-Lis Abdominoplasty, it has an additional horizontal scar along the lower chest fold.

How Does a Surgical Scar Change over Time?

After a surgical incision is created, the healing process involves three key stages. These overlap and progress with time.

1. Inflammatory Stage (0 – 1 week): This focuses on protecting the affected tissue. Clots form to control bleeding, and immune cells arrive to clear bacteria and damaged tissue. The body intensifies its defence and repair mechanisms, so redness, swelling and tenderness are common.
2. Proliferation Stage (1 – 4 weeks): Fibroblasts (responsible for wound repair) deposit collagen to fill the wound and close the skin. Your blood vessels begin to regenerate, providing essential nutrients and oxygen to support further repair. The beginnings of scar tissue form, but it remains fragile.
3. Maturation/Remodelling Stage (1 month – 12 + months): During this final stage, the initial scar tissue remodels. The stronger type I collagen replaces type III collagen. The scar slowly flattens, softens and fades. This process can take a year or more.

Surgical technique & the effect on scarring

Dr Dona is an experienced Reconstructive and Plastic Surgeon with advanced expertise in techniques designed to support optimal healing and minimise the appearance of scars. This includes precise surgical technique, careful incision closure and refined suturing methods using fine, low-reactivity sutures.

Early Wound Care (First 6 Weeks)

Early surgical wound care focuses on preventing infection, protecting the incision and managing your scar. In the first 48 hours, keep your wound dry. After that, showering is generally acceptable, but you must check with our team and follow your post-surgical instructions. Baths and any water immersion are to be avoided for a full four weeks.

When washing your wound, gently wash the area with soap and water, but do not scrub. Gently pat dry with a clean towel.

Inspect your wound daily for signs of infection, such as redness, tenderness, warmth or any foul-smelling drainage.

Protect the wound by exercising common-sense caution, avoiding tight-fitting clothes, lifting heavy objects, and strenuous activities that could put pressure on the incision.

The Importance of Compression Garments

Compression garments apply constant pressure to the wound, encouraging optimal scar healing in various ways:

• Addresses appearance: Pressure reduces vascularity and redness (erythema) while supporting the softness and texture of the scar.
• Reduces swelling and fluid buildup: Pressure promotes lymphatic drainage and better circulation, therefore reducing swelling (oedema) at the site.
• Speed up healing: By supporting tissues and reducing tension on wound edges, the incision can heal faster.
• Minimises keloid and hypertrophic scars: The constant pressure inhibits excessive collagen synthesis, preventing the formation of thick or raised scar tissue.

Dr Dona typically recommends that patients wear their compression garments continuously for the first six weeks following their Abdominoplasty procedure.

Why Do Some People Scar More Than Others?

People scar more than others for various reasons, and some scars are more pronounced on certain areas of the body. In essence, the extent and visibility of your scar will depend on a combination of environmental and biological factors, such as:

• Genetics: Your DNA heavily influences how your skin produces and remodels collagen. If you have a family history of excessive scarring, you will be more prone to developing thick, raised scars.
• Age: Younger skin typically produces more active healing responses, leading to firmer scars, while older skin produces less collagen, resulting in thinner, less flexible scarring.
• Skin Type and Tone: They can affect specific scar types. For example, darker skin types are more prone to developing keloid scars and, to a lesser extent, those with red hair.
• Scar Location: If skin is stretched tight or covers moving joints, it increases mechanical tension, which stimulates extra collagen production. Consequently, these areas tend to scar more significantly.
• Healing time and complications: If a wound takes a long time to heal or is complicated by infection, it is more likely to leave a visible scar.

Hypertrophic and Keloid Scars

Hypertrophic and keloid scars are both the result of excessive collagen deposits during healing. Some individuals are more prone to developing these scars than others. The main difference between the two is that hypertrophic scars remain confined to the original wound boundary, while keloid scars extend beyond the boundary.

Hypertrophic scars – are thick, raised and red or dark-coloured. They occur quickly and are more common than keloid scars. Unlike keloids, they remain confined to the original wound boundary and may naturally regress or flatten over 12 to 18 months. They can affect anyone regardless of age, race or skin type.

Keloid scars – are thick, raised and red or dark coloured scars that extend beyond the original wound boundary. Unlike hypertrophic scars, they can develop months or even years after the initial injury, and will not naturally regress on their own. They are more common in younger people and those with darker skin tones.

The HeaLED Program at Bella Plastic Surgery

At Bella Plastic Surgery, we provide all patients with a tailored and comprehensive post-operative care program to help optimise their healing outcomes.

This plan involves multiple weekly in-clinic post-operative care visits with our nursing team that continue for several weeks. It enables our nursing team and Dr Dona to carefully monitor your progress, initiate post-operative treatments and wound care, and ensure you achieve all necessary recovery milestones.

Part of this program includes our heaLED Post-surgery care program, specifically designed to promote optimal scar healing. It includes various industry-leading modalities that accelerate wound healing, reduce swelling and discomfort and minimise the appearance of scars.

A core component of our heaLED program is LED light therapy, a non-invasive treatment that:

• Reduces swelling and inflammation
• Helps minimise pain and discomfort
• Accelerates wound healing and tissue regeneration
• Optimises scar formation for neater, more refined scars

LED Therapy typically begins on the day of your hospital discharge, although the timing may vary depending on your procedure.

Rejuran Therapy For Scar Healing

Another important component of the heaLED program is Rejuran Therapy. Rejuran contains polynucleotides, which are bioactive molecules derived from salmon DNA. Polynucleotides are clinically proven to stimulate cell rejuvenation, repair damaged skin and improve elasticity.

When used in surgical aftercare, Rejuran works at the cellular level to:

• Boost fibroblast activity, encouraging the production of healthy collagen and elastin
• Strengthen the skin’s structural integrity around the incision site
• Improve hydration and skin barrier function, making the skin more resilient during healing
• Refine scar texture and pigmentation, leading to smoother, less visible scars over time

Silicone Sheets and Gels: Do They Work?

Silicone sheets and gels are highly recommended for scar management. They help flatten, soften and fade red, raised or dark scars (including surgical and keloid scars) by hydrating the skin and regulating collagen production.

Silicone sheets and gels are equally effective; the best results come from whichever method you use consistently for a minimum of 8 to 12 weeks. Silicone sheets are best for large, flat or surgical scars where sustained pressure is beneficial. Alternatively, silicone gels are useful in areas where the skin is not stable, such as over joints, the face or awkward body contours.

Silicone sheets and gels should not be used immediately after surgery. The skin should have fully healed before starting treatment. For optimal assaults, it’s recommended to use the products for 12 to 24 hours a day for at least two to four months.

When to Consider Laser, Microneedling or Further Treatment

Most surgical scars settle well, but some can remain red or lumpy for a while. Additionally, some individuals are more prone to keloid or hypertrophic (raised) scars. In these instances, treatments such as Microneedling and or Laser can help address the appearance and texture of scars. It will also increase the likelihood that they will become thick and red again.

Traditionally, it was suggested that patients wait a year before undergoing further treatment; however, recent studies indicate that early intervention is key.

Laser

Laser uses focused light energy to remodel scar tissue, soften and smooth textural irregularities and fade discolouration. Various lasers can be used.

• CO2 or Erbium Laser (Fractional Ablative Lasers): Considered the gold standard for thick, raised, and indented scars, they vaporise microscopic columns of tissue, promoting deep collagen remodelling to flatten and smooth the scar surface.
• Fraxel and Nd:YAG (Non-Ablative Lasers): These lasers penetrate the skin to stimulate collagen without damaging the top layer, resulting in less downtime.

When possible, early intervention with laser is ideal. A 2025 study has indicated that commencing Fraxel Laser treatment within one to three months after surgery often yields the best results for minimising scar formation and fading discolouration. However, if your scar is old, a laser can still break down rigid scar tissue, making it blend in more naturally with surrounding skin.

Microneedling

Microneedling can address the appearance of surgical scars by breaking down disorganised scar tissue and stimulating new collagen and elastin fibres. As with Laser, research indicates that early intervention (about six weeks post-surgery) yields the most dramatic cosmetic and textural changes by interrupting immature scar development.

Cosmetic Tattooing for Scar Camouflaging

Cosmetic tattooing is often called scar camouflaging or paramedical tattooing. It can be useful for addressing the appearance of strongly coloured scars by depositing a custom-blended, flesh-toned pigment into the scar tissue to neutralise discolouration and help blend the area seamlessly.

Patients must wait 12 months before commencing tattooing, as the scar tissue must be fully mature, stable and completely healed. Tattooing cannot be performed on keloid scars because it may irritate the tissue, worsening the scar.

While cosmetic tattooing can improve the appearance of scarring in the appropriate patient, it’s important to understand that no scar will be completely erased.

The Importance Of Avoiding Sun Exposure

It’s exceedingly important to keep your scar protected from the sun for the first 12 months or until it has fully matured and lost its pink or red tones. If this scar is exposed to the sun, the following can occur:

Post-Inflammatory Hyperpigmentation (PIH): Young, healing scar tissue is highly photosensitive. When UV rays hit a fresh scar, pigment-producing cells become overly active to protect the vulnerable skin. This leads to brown or black discolouration, which can take months or years to fade.

Impaired healing: UV exposure breaks down collagen and elastin, which are the structural building blocks of skin that need to be repaired. This UV exposure causes the scar to become thicker, wider or lumpy.

How and When to Massage Your Scar

Post-surgical massage helps break down fibrous tissue, prevents skin from adhering to underlying muscle and improves mobility. Your scars should be fully closed before commencing massage, with no scabs or drainage (typically this is around two to three weeks post-surgery). Before commencing massage, always check with the team at Bella Plastic Surgery.

The scar should be massaged for five to 10 minutes, two to three times daily.

To massage the scar, wash your hands, then apply an unscented lotion, such as Sorbolene, to reduce friction. Using the pads of your fingertips or thumb, apply firm but moderate pressure (keeping the massaged comfortable at all times), moving in the following directions:

• Circles: Create small circular motions (clockwise and counterclockwise) along the length of the scar.
• S-bend: Stretch fingers on the opposite sides of the scar to create an S-bend.
• Vertical & horizontal: Massage the scar up and down, and from side to side.

When Should You Contact Your Surgeon About Your Scar?

If your scar is new, you may need to contact Dr Dona if you think you may have a complication or the wound is not healing well. Please get in touch with the team immediately if you notice:

• Signs of infection – increased (and spreading) redness, warmth, swelling or any cloudy discharge.
• Systemic symptoms – a fever, chills or generally feeling unwell
• Uncontrolled bleeding – bleeding that does not stop after applying gentle, continuous pressure
• Increased pain – if the pain gets worse instead of improving
• Wound dehiscence – if the wound appears to be pulling apart

Your scars will take approximately 12 to 24 months to mature. If, during this time, you feel that the scar is becoming thick, raised or extends beyond the parameters of the incision, you should contact the clinic immediately. Additionally, please get in touch if:

• The scar becomes tender, painful or itchy
• The scar becomes darker instead of fading
• The scar considerably tightens, affecting your mobility

Finally, if, after 12 to 24 months, you are unhappy with the appearance of your scar, we recommend that you contact the clinic to discuss further procedures that may help minimise its appearance and texture.

References:

https://pmc.ncbi.nlm.nih.gov/articles/PMC11711943/