Has Anyone with Hypertrophic/Keloid Scars Had PS?

Hi all,

I am about 7 months out and already looking towards potential future plastics, however, I am very prone to hypertrophic scars and keloids. I had my gall bladder out in an open surgery about 3 years ago and the scar is horrific. Part of that was my own fault because I waited too long to get the staples removed. The RNY lap scars are relatively small though. I just wonder what others who are prone to this type of scarring have heard from plastic surgeons - do they recommend against it? Or do they have special procedures and treatments that help minimize the potential?

Any info is greatly appreciated!

Hi Norma,

It turns out I had a keloid on my back from a lipoma removal back in 2004.  My plastic surgeon revised the scar when I had my LBL thinking it was just hypertrophic.  In many people, surgery on a keloid causes its return, and sometimes even bigger than before.  He was surprised when he received the biopsy results that it was keloidic tissue.  He told me that had he had the least suspicion, he could have performed a radiation treatment to the site after removal which has offered very promising results, (my subsequent internet research says it's "expensive." ) It's a localized treatment that only treats the specific area and is not intense enough to reach the deeper tissues. Risks are minimal. He did tell me to be religious in my use of silicone tape on the scar for at least a year and not to expose it to sunlight at all.  If it is not healing properly or continues to produce scar tissue (which it doesn't seem to be yet), there is a laser he can use on it to atleast flatten it a bit.  The resultant scarring from my LBL and BL do not appear to be developing any keloidic tissue.  I am using both silicone tape and cocoa butter/vitamin E massage.  The only incidents I've been having are spitting stitches and hairs on the incision line in the girlie area having become ingrown and taking their old time reaching the surface...both normal.  I understand that the type of skin also has something to do with it.  I also read that thicker skin, such as that on the back, tends to develop keloids moreso than say on your abdomen.  Funny thing is, I had two c-sections, the first of which left a horrific snake on my stomach.  My ob/gyn for the second delivery said she'd fix it and fix it she did.  I went from a thick, raised red snake to a completely flat tiny white line visible only if I looked for it.  She told me she'd inject steroid into the tissue on closure.  Whatever it was, along with her better technique, certainly helped.

Of course, only the surgeon can offer a medical opinion, but I wonder if your tendency is only mild to moderate if you'd feel better living with a raised scar in normally-clothed areas as opposed to excess skin.

Good luck with your weight loss journey, and I hope plastics can be in your future if you desire it.

Terri

Terri,

Thank you so much for your very thorough reply. This is all extremely helpful information and gives me hope that plastic surgery is not out of the question for me. I also actually have a large keloid on my back as well, that's great that your surgeon removed it when you had your LBL, I never even would've thought of that. That's encouraging that your PS scars are normal!

Thanks again,
Norma

 Norma,

I have hypertropic scarring and have had several rounds of PS. My LBL scars are fine - thicker in some places but they don't show so it's fine. I also had an upper body lift, breast lift and arm lift. The breast lift scarring isn't really visible. The back of the upper body lift is barely visible but right where the side of the bra band is, the scar widened and thickened. The worst scarring is from the arm lift. Part of that is my fault because I went back to work too soon and I am a fitness/strength instructor. Part of it is the placement of the scar. Even though red lights went off in my head when my PS said the best results are attained with the incision on the BACK of the arm, I went along with his advice. WRONG. I have since undergone numerous laser and steroidal injections to try to lessen the thickness and redness of the scars. They are much less thick but the redness is still there. According to the doctor (a laser expert), the effects of the laser will continue for up to a year following treatment. However, I should not have waited so long to have treatment. If you have your arms done, please discuss your potential for hypertropic scarring before surgery and find out what your surgeon is willing/able to do regarding the scarring. I have since had a revision with another PS and he started laser treatment on my scars within weeks of the surgery so the scarring is already much less visible and not red. I will be undergoing another treatment next week and these treatments have not cost me anything extra unlike the arm laser treatments. Good luck! Do not let your scarring issues stop you from getting surgery but get as much info as you can and get your PS committed to helping you deal with scar issues! 
CeCe

Cece,

Thank you SO much for sharing your experiences with me, it's so helpful to have this information. I definitely plan a breast lift and this was probably one I was most worried about, followed by the arm lift. I will of course have to wait to see how my skin is once I get to goal, but I am pretty sure I'm going to need the breast lift and a tummy tuck at a very minimum. I definitely will discuss the scarring with the plastic surgeon and find one that is committed and has experience with these scarring issues!

Thanks again,
Norma

Hi Norma,
My experience with scarring is bizzare. I had "open" gall bladder surgery in 1989 and formed a keloid. C-section 1996 and the scar is barely visible. RNY 2005 scar again barely visible. BL/BA with Brachioplasty in 2008 formed keloids at all surgical incisions. I did use silicone strips 24/7 for about 6 months without much improvement and also had three laser treatments without any noticeable difference. Those keloids are fading on their own with time, but are still very noticeable (I have no regrets because the "bat wings" I had were far worse then the keloids). Seven weeks ago, I had an LBL and so far, the incisions look FANTASTICK!!! SO GO FIGURE!?!?! TOTALLY DIFFERENT BODY PARTS EXPERINCING TOTALLY DIFFERENT SCARRING!!!
I started using a silicone gel cream about 2 weeks ago on my LBL scar as well as the old keloids and I'll keep you posted on the progress.

Thanks so much for the info, kpipala. I have a horrible keloid from my open gall bladder surgery too. I think the lower on the body, the less chance of keloids. My appendicitis scar has faded to nothing, it is right at my bikini line. That's encouraging about your LBL scar!

Thanks again,
NN