Skin removal surgery trades skin for a scar. That is the whole bargain, and there is no version of it without one. What varies is where the scar sits, how long it is, and how well it settles — and the last of those is partly within your control.
They are red and raised at around three months, and pale and flat in most patients by twelve.
Where the scars sit
| Operation | Scar |
|---|---|
| Abdominoplasty | Low and transverse, hip to hip, below a bikini line in most patients, plus a small one around the umbilicus |
| Fleur-de-lis | The same, plus a vertical midline scar — the trade for taking in width |
| Panniculectomy | Transverse, usually lower and longer |
| Lower body lift | Continues around the trunk, sitting under a waistband |
| Arm lift | Inner upper arm, armpit to elbow — the most visible. More here |
| Thigh lift | Groin crease, and down the inner thigh where a vertical component is needed |
| Breast surgery | Around the areola, vertically, usually along the fold. More here |
What happens over twelve months
| When | What the scar looks like |
|---|---|
| Weeks 1–6 | Covered by Prineo and Micropore; surrounding skin bruised and swollen |
| Week 6 | Dressings off; pink, flat to slightly raised |
| Month 3 | Reddest and firmest. This is the low point, and it is normal |
| Month 6 | Colour fading, softening under the fingers |
| Month 12 | Pale and flat in most patients; final review with Dr Kumar |
The protocol
Scar care here follows a set protocol rather than being left to chance. Prineo and Micropore go on at surgery and stay for six weeks. A compression garment is worn for the same six weeks. After that, Dr Kumar’s nurses take you through silicone and massage, and review the scars at every visit through to twelve months.
What makes a scar worse
- Going back to activity early. Tension across a healing scar widens it — the commonest cause of a poor scar, and the one most within your control.
- Nicotine. Complete abstinence from all nicotine, not just smoking, for eight weeks before and after body contouring after weight loss.
- Sun. Keep new scars covered for the first year.
- Skin type. Some people form thicker scars regardless of technique; a personal or family history of keloid is worth raising before surgery.
- Wound problems. Separation or infection leaves a wider scar. Ends of long scars and areas of highest tension are the usual sites.
- Nutrition. Protein, iron, B12 and vitamin D are commonly low after bariatric surgery, and healing depends on them.
Scars after weight loss behave differently
Skin that has been stretched and then emptied has a damaged dermis, often with stretch marks through it. It is less elastic and under more tension at closure, so scars in this group are more likely to widen than in a patient who has never carried substantial weight. That is worth knowing in advance rather than discovering at three months.
Common questions
Can scars be removed? No. They fade, and a widened scar can sometimes be revised after twelve months.
Do creams work? Silicone has the best evidence. Most others do little.
Will the scar show in underwear? An abdominoplasty scar is placed to sit below most underwear and swimwear. A vertical or arm scar cannot be hidden.
When do they look their best? Twelve months.
Is laser worth it? For most patients, silicone, time and sun protection do the work. Dr Kumar will say if he thinks anything further would help.
Next step
Ask to see where every scar will fall — they are marked on you at consultation. Bring a GP referral; it is required to see Dr Kumar. Call 1300 267 726. More about recovery and body contouring after weight loss.
The initial consultation with Dr Kumar is $400, with a Medicare rebate of approximately $88 where you have a GP referral. Surgical fees are quoted individually after your consultation, in a written itemised quote.
All surgery carries risks, and individual results will vary. Read more about the risks of surgery here. A GP referral is required to see Dr Kumar.
Dr Rohit Kumar (MED0001630444) Registered medical practitioner, specialist plastic surgeon (specialist registration in surgery – plastic surgery).
