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“I’ve had surgery and experienced scar tethering in the past. I’d like to have more surgery, but I see so many different types of scarring on online forums and chat groups, and I’m really worried it will happen again.

Is there a way of removing it – and how can I make sure it won’t occur again?” 

– patient

healed abdominoplasty scar Dr Sharp
Dr David Sharp, plastic surgeon in Brisbane, profile image

Dr Sharp:

Scar tethering is sometimes part of your body’s scar healing, with scar tissue under the skin adhering to deeper structures.

The scar maturation process takes about 24 months in total, and during this period the scar progresses through a number of phases and presentations.

How it looks, feels to touch – and the sensations in the area – also change during this period. There are things that patients can proactively do at home during their healing period to help prevent and reduce scar tethering. It requires a long term daily time commitment, but patients who engage with this aspect of their healing usually reap the benefits, reducing  scar tightness and appearance.

During the early phases of healing, everything tightens and can feel very firm and thick. During this time we generally recommend massage as your best prevention/optimisation tool. This can be done without lubrication or with the assistance of an over-the-counter silicone gel from the pharmacy to help with the movement. If you have a surface wound, you can also use our scar gel. 

Following your post operative instructions and being patient are the best tools in the early stages of recovery, to optimise your results. Attending your post operative consultations so your surgeon can assess your scar development is also essential.

Prevention can be difficult, especially if the area has been operated on before and previously experienced tethering. Sometimes the surgeon can try to release the scar using subcision, whereby they undermine the fibrous bands holding the scar down, however this is not always successful, particularly on tighter areas where the skin is stretched across the bone such as the cheek or jawlines. Research shows that this is best performed once the scar has started to mature.

We highly recommend that any patient experiencing scar tethering engage with a scar therapist in the early stages of development – these are occupational or physiotherapist – who can achieve measurable improvements with regular therapy sessions. Our team can provide a referral, so the therapist understands the procedure you have undergone and the treatment/s we are performing in clinic as well, if applicable.

Scars will soften and loosen with time. If you are genetically predisposed to dark or prominent scarring, Fraxel laser can be used to improve colour and encourage a flattening of the scar. Lasers can commence from week 6 post op and 3-4 sessions are usually recommended, 4-6 weeks apart.

When viewing scar image online in forums and surgery websites, it is important to judge these with an understanding of whether the patient has:

  1. a genetic predisposition to scarring
  2. whether they smoked or vaped postoperatively
  3. whether they contracted a postoperative infection
  4. whether they attended their surgeon’s clinic frequently for scar therapies and checks
  5. how strictly they followed post operative instructions
  6. how often they utilised a healthcare team with scar specialists
  7. how long each day they engaged in incision massage using scientifically proven scar products during the first 3-6 months after surgery.

These factors all significantly influence scar development, but are rarely disclosed alongside scar imagery.

During your recovery period you will have routine post op consults booked, but we encourage you to come in and see us for a checkup – or to consult with our post op care team, who is experienced in non surgical scar optimisation strategies. I hope this information assists during your healing process!


The above information is general in nature and does not constitute medical advice. All surgery carries benefits and risks, and we recommend visiting the specific page related to the procedure you are interested in to learn more. 

The photo above shows a patient before and at 3 months post abdominoplasty with Dr Sharp, and again at 1 year, half way through her 24 month scar maturation process. The changes to the scar are already visible, and will continue over the coming 12 months.

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