Hi there, I was about 21 when I had my J pouch surgery and my incision sort of pulled open when the staples were removed bc I was so thin at the time. And bc I was so thin, the healed skin was pulled very tight and uncomfortable.

My parents gave me the gift of taking me to a plastic surgeon who, unfortunately, said it had to be done in a two step process.

The bottom half of the scar was where is was pulled tight so that's what he fixed first. I would have preferred the top half first as that was what was visible and prevented me from wearing a two piece bathing suit.

After all the illness and multiple surgeries, that one plastic surgery was all I could take. I never went back to have the top half of the scar fixed.

I also never had anything done with the stoma sight which, for some reason, left me with a fatty bulge on my abdomen.

I just accepted that I needed to conceal it. Once in a while I still wore a two piece deciding I was proud of just being me, scars and all. For me, to go under the knife again just wasn't worth it. I had enough and was finished with it all.

At 43 none of it matters so much anymore to me. Although, I do dislike the bulge over the stoma site. I'm not so thin anymore so the bulge actually is visible under clothing.

I guess this doesn't answer your question so much. My apologies for rambling about my own experience.

However, my experience over 20 years ago was that the scar appearance could be minimized with surgery. The half that I did have repaired does have a much better appearance, and continued to improve in appearance over time (i.e. as the plastic surgery lines faded).

I would say my results were very good....and that was over 20 years ago. I would think procedures are more advanced now so it seems strange that a surgeon would tell you it would be so difficult to do. I can see where improving the appearance of the stoma site may be a challenge; since I never considered it, I can't speak to that part. I would recommend a second opinion.

Good luck and best wishes!

FQ,
I have 9 scars on my abdomen ranging from my first colostomy scar at age 2 to the central one that we all know and love that split open a dzn time plus 3 stoma scars (had to move the pouch due to hernias) and an assortment of other scars due to disasters...like most of us my stoma scars are deep, quilted and...well ugly...so after years of emergency surgeries and disasterous scars (NOT the fault of my surgeons who are wonder stitchers but my body that doesn't heal well)...I went to see a plastics man...the first time I had a consult I was 28 and I was told that I had 'one really ugly scar but that it was too deep and he couldn't fix it'...this time I saw a guy who promised me the moon and an abdomen like Shakira! Needless to say that the result was almost worse than the original scar (he added a new one!!!!) and it looked like a down filled quilt...I went back 2xs for 'touch ups' under major local anesthetic...refused to allow him to put me to sleep again...so far the central scar looks ok, the smaller ones so-so and the stoma scars are horrible! I still need at least 2 more surgeries for it to look even mildly acceptable but I am back to work so it will have to wait...
My advice...find someone good and honest who gives you the odds of success honestly...discuss everything first (find out if you need muscle restructuring or not...That is the biggie...I didn't, mine was skin deep plus very large fatty cysts and a couple of hernias)...The fatty cysts are gone but the new scars are horrific so be percise with him and realistic with your expectations...it is doable just need the right hands to do it!
Sharon

I realize that this could be a different issue for women. My scars were pretty bad, but after a few years the redness faded and the scars softened. I think it took a full 5 years to reach maximum improvement. The scar where the stoma site was, which healed by granulation, is a big oval shaped concave scar. However it has faded over time. Plastic surgery is expensive, not covered by insurance and does not insure a significantly improved scar, especially for people who generate a ton of scar tissue any time they are cut open.

Regarding tattoos, I hate them on a woman. To me they look trashy and I am instantly turned off if I see a tattoo on a woman's body. I do not understand them, but it seems like it is a method by which a person chooses to individualize himself or herself. I interpret that as a lack of self esteem to use the force of one's personality as a means to be distinguished. Regardless, even the most artistic ones are a major turn off. I would say don't do tattoos period.

It is true that, generally, plastic surgery is not covered by insurance. In my case, my parents were able to get it partially covered bc my skin was pulling so tight that it was very uncomfortable. At the time, they managed to get it deemed medically necessary.

fq - tattooing might work just fine. Look at this gorgeous tattoo on a woman who had a double mastectomy. It's just spectacular.

Or you could 'zipper' your scar. I would think it would bring a smile to your face every time you looked at it.

kathy

My Hubby had a henna tatoo placed over/around his mainline incision (it's about 15inches long and curves off to the left)...he had them tatoo a lizard over it...looked great...by the time the henna wore off he was finally used to it and decided not to tatoo another one. Henna is a good idea because it wears off after about a month...so you can change the design whenever you like (just skin test it first...Some of us are allergic to it)...
Sharon

thanks guys. I have a second opinion in a couple weeks and will let you know how it goes. Sometimes I wonder if I spend all this money /effort on plastic surgery and have to be cut open again or pregnant, it would mess it up! Guess no one can predict that though

I wouldn't worry about the future so much...we cannot know if we will be reopened one day but at least for now you can have the abdomen that makes you happy...
Sharon

quote:

if I spend all this money /effort on plastic surgery and have to be cut open again or pregnant, it would mess it up!

If they did a C section on you in the future, wouldn't they make a horizontal cut? My original colectomy scar is a vertical slice - up and down, from the lower part of my rib cage to about 1" above the base of my penis. I just saw the movie Prometheus and in it the main character has to have an emergency C section because she is pregnant with an alien fetus, and they do a horizontal cut on her with robotic lasers (the surgery is actually shown and not left to the imagination). It's actually the only C section I have ever seen, but I did some quick research and what I can see is all horizontal cuts:

http://www.babycenter.com/c-section-scar-photos

So if fq has a vertical scar I am not sure I understand why worry about a C section "messing it up." This will be a whole new horizontal scar which will cross the old vertical one.

CT,
Even though most C sections are now done horizontally they occasionally use an old vertical scar if it pre-exisits...Then again there is always the possibiltiy of 'other' surgeries...unfortunatly.

quote:

Even though most C sections are now done horizontally they occasionally use an old vertical scar if it pre-exisits...

So if she cosmetically improves the vertical scar, paying $5,000 or more to do so, they will use that pre-existing vertical scar for the C section? Will that not defeat the purpose of cosmetically improving the vertical scar, such that she will have to pay another $5,000 plus to improve it all over again? How many times can you keep opening up the same scar and hope that it will look the same or not as bad?

Every case is different so it's not possible to generalize. As I posted earlier, the top half of my scar was not repaired via cosmetic surgery bc I simply decided I had enough.

However, two years later they reopened that half of the scar to remove adhesions. The original incision pulled open a bit and healed as a wide scar. But when I was opened again for adhesion removal, I wasn't so thin and we kept surgical bandages on the incision longer. The result was a much thinner scar.

I'm just commenting to say that reopening doesn't necessarily mean a worse outcome.

hi friends,

i got another plastic surgery consult. he said my scars aren't that bad considering what was done to me... but he CAN improve them. 'What don't you like about the scar', he asked? I replied: the length, old staple marks, raised in some areas, width in some areas.

He said overall scar length will be the same, which I was disappointed to hear because that's one of the things that bother me. It's a long midline incision, about 10-11". I was hoping to be able to show my midriff again, but I guess that's asking for too much

he said he cannot change the length of the scar and I am too skinny for a tummy tuck. but what he can do is excise the scar AND staple marks and re-suture into a thinner line. He said he could make it a pretty good improvement. that's about a 1.5"x 12" piece of skin sliced off! And he would also revise the ostomy scar so it is thinner and even with the stomach. Price: $2500.

Now I am thinking is it worth it to replace one huge scar with another big scar (although cleaner-looking). But I am REALLY not happy with my current scar and it reminds me of the trauma (especially the older emergency scar done by Dr. DoLittle, lol)

It would need to be done under anaesthesia, but I would be awake. It has been 8 months since my crazy j-pouch surgery (which took me almost as long to recover from). The thought of being in the hospital again makes me feel sick/anxious. But if I want to do it, the timing is pretty good now.

He also said I would only have a couple of days downtime....?

i still think about if they have to open me up again in future (pregnancy stretching out, c-section, pouch-related), which would mess up the new scar. but as Sharon said, shouldn't worry about future maybe's now.

What do you guys think????

Do the risks outweigh the rewards? And when he says only a couple days of downtime... what if there are complications? What type of complications could happen? If so, what does that really mean in terms of recovery, etc..

Believe me, I do understand that it is hard to get the horrific past cleared out of your head, but maybe some therapy could help with that, verse subjecting your body to more potential trauma?

Everything seems OK to me, but maybe it is a bit too soon. Generally, plastic surgeons like to wait about one year for scar revision, to see what natural changes will occur before attempting further surgery. It can take that long for final remodeling of the skin. But, it can vary from person to person. The fact that you have differing opinions sort of speaks to that.

Plus, from what you write, it sounds like you are still traumatized by the illness and surgery, and it may be too soon to voluntarily experience hospitalization and surgery again. I think this is especially true if the plan is for local anesthesia with some sedation, instead of general anesthesia. Don't get me wrong. I think surgery under local anesthesia is great, but you have to be emotionally ready for it. Even though you are sedated, you hear the operating room chatter and the sounds of the instruments and machines, and feel the tugging and snipping on your skin (but no pain).

Another thing you need to get clarification on are the keloids. People who form keloids tend to form keloids with every incision, so be sure to inquire about your risks of this recurring.

Personally, I would give it more time, but if you are highly motivated, it may be right for you.

Jan

thanks!!! i think you are right - i will probably wait 2-3 more months....after all the 1 year mark is around the corner.

i didn't think about being awake enough to hear, see and smell the operating room activity. that might be a little unsettling... maybe they will let me bring some headphones???

good question about the keloids. i asked the doctor and he said he can inject steroids if it recurs. does that sound good???

apparently, he does cancer reconstruction surgery and is chief plastic surgeon at a university hospital (so not just a beverly hills boob-job type plastic surgery, LOL). so I am hoping his work is good...

I agree I am probably trying to "erase" a part of my past or blur it a little. I am hoping it will give me more confidence or help me come to accept things more. maybe I am fooling myself. But I think it might be worth a try. This is coming from someone who was too scared to get ANY type of surgery and almost died from UC because of my fear of surgery. so i don't take surgery - especially cosmetic surgery - lightly. I don't know if I will get what I want from it when all is said and done. i might even regret it. i even asked the nurse "what happens if I'm not happy with the results"? And she said "that usually doesn't happen". Maybe doctor egos talking, lol.

How about a tattoo?

kathy

Glad the surgeon is not a "Nip/Tuck" guy, but a real reconstructionist! Not sure how well steroid injections work for keloids, but a good question to get clarified. Sometimes doctors (particularly surgeons) tend to accentuate the positive and play down the negative too much. What you need are percentages. Like how frequently do keloid recur in the same patient? What is the complication rate? It does sound like this guy was not promising you a rose garden, and was giving you realistic expectations.

If you do not want to be awake, you can ask for a general anesthetic, but that will add to your cost. So ask about that too, if you want opt for a general. But, even with full anesthesia, you may not be ready to face an OR scene just yet. But, who knows? With being for something positive, you may ave a whole different outlook and it could possibly help get over the association (as long as everything goes well).

Jan

FQ,
My last 2 scar revisions (and the next and hopefully last) were done under local without sedation (fine, I don't scare easily)...I refused to go under general again because of the previous outcome (both medical and the surgical) so I sucked it up, gave instructions (yup!) and told jokes while shaking like a leaf...it is not for the faint of heart of the easily traumatised...so think first before you head in...next, he did my midline first and no, I would not say, if you want a really good result, that you can go back to your normal life 2 days later...count a minimum of 1 week before undertaking anything even remotely strenuous, like tying your shoelaces. Next, 2 weeks before pulling up socks (this is not a joke.) You do not want to put any undo pressure on the suture line, no twisting or turning or lifting because the result depends on how well you heal and if you are stressing the scar it will heal funny...you don't want to be popping sutures...my surgeon had me wear a light girdle to protect it and avoid too much bending or stretching...this is not like getting your ears pierced...it is still surgery even if they don't cut muscle and gut...so, if you can bare it (or bear it!)..wait a while until you have 2 full weeks in front of you for some rest and free time to heal properly.
ps...cortisone shots help with the keloids but there is no guarantee that they will stop them 100%.(hubby had the shots done into his scar and it worked 60%)
Sharon

I agree with Jan that it might be a little soon for another surgery from an emotional standpoint. Maybe there are other things you could do to symbolically leave the surgery behind and "blur" it as you say. I know this sounds silly, but if you have any ephemera from your hospital stay, like unimportant paperwork, you could do a little ceremony and burn it to show that you are ready to move on!

More practically speaking, I would try to wait and see what happens to your scar over the next year or so. I had a surgical procedure a few years ago that left a scar that I thought would never go away. It wasn't a midline incision or anything, but it was conspicuous and it bothered me a lot. Recently I went to a new doctor who saw the operation on my history and said "Your chart says you had X but I can't find the incision"! Time can do a lot for scars, and it's free and painless, but you won't know if you don't wait.

Oh, and one more thing. If these are really keloids (not just hypertrophic scars), then be sure NOT to expose them to the sun for at least a year. They will tan darker than your skin, and it may be permanent.

Jan

As mentioned, I had plastic surgery repair of part of my scar bc it was pulled so taut that it was very uncomfortable...I was super thin due to years of UC.

It is true, you will still have a scar. No way around that. However, it fades quite a bit over the years.....and I do mean years. Also, staple marks fade....no plastic surgery on those.

As I also previously mentioned, I opted not to mess with the top half of my scar which, unfortunately, is the part that shows in a two piece swim suit. At the time, as a young girl, I thought that was important to me. However, you do get to a point where enough is enough. I was grateful to be healthy, didn't want to be messed with anymore and didn't want to take chances with my health.

So I found 1 piece or split suits that covered most of the incision. That was just fine and I never looked back.

I would never judge anyone's decision. It is your body. To me, I will say, it's not worth the risk. I cut my losses and moved on....gladly.

well... i went through with it.

i had midline and ostomy scar revision last week. i'm still recovering. Sharon did a good job describing post op restrictions. I am walking with a hunchback and can't tie my shoes lol. I was on pain meds for 2-3 days and my incision is sore and itchy. i still have dressings on, which won't be removed until my follow-up visit next week.

i don't know what the final result looks like since the bandage/dressing is still in place. i have already strained my abs a few times by accidentally (bending over to pick up, twisting and turning and straining on toilet), so i hope i didn't mess things up!!!!! it is very difficult to remember to restrict this type of activity.

the first couple days post surgery i regretted and questioned why i did it. even now, i am not sure. but it kind of feels good to "throw away" the old scar and its negative memories.

even though i was on twilight anasthesia, i guess i fell asleep because i don't remember a thing...which is good. it was the first surgery i have had where i wasn't completely scared out of my mind, so it in some way changed my view about surgeries in general.

my tummy feels really tight and i noticed i get full faster. my belly looks kind of distended and funny right now, but hopefully things will settle and look better. kind of nervous to see when the dr. removes the bandages!

now i guess i wait and see.....

Hope all is well and you are pleased with the results when you finally get to see your new scar

$2500 sounds like a bargain to me, I would get mine done if that's all it costs !!

My BCIR surgeon does tummy tucks on continent ileostomy patients, so it can be done. I had a tummy tuck prior and it stayed in tack luckily.

I want to so more surgery to my scars so interesting thread.

If it brings you peace mentally, its worth the investment. I got the Jpouch to improve my quality of life. If fixing the scar provides you some form of mental comfort,then 2500$ is well worth it.

I would still get a few more opinions as certain surgeons like to oversell what they can do for you.

Im glad Im a guy and scars only make us more badass!

it's funny, i feel the exact opposite about my incision scars.

i wear my scars like a badge of honour, reminding me of what I have been through and came out stronger afterwards.

natural tattoos in my mind.

hi everyone just wanted to give an update.

my bandages are off and i love my new scars! they were revised much better than i even thought possible. my midline incision used to be wide and have staple marks. now it is a thin line and no staple marks. ostomy site is a very thin horizontal line and no caving in or crater look. the surgeon did a good job. my tummy feels really tight though and i wonder if i have more adhesions again? well, it's done so i guess that's that.

overall, i feel much better about my scars and everything psychologically. my scars no longer bother me, actually i really like them now and even though tummy will never be perfect, it is a big improvement. knowing my luck, irony will soon come into my life and next thing you know i need another surgery which will ruin my new scar! gotta enjoy it while it lasts. LOL....

Hi FQ,
Congratulations...
I think that it is great that you decided to get the abdomen fixed and that you are pleased with the outcome...
Let us know how the healing progresses...
Sharon