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An operation leaves an unattractive tummy scar

by Dr Howard Lee

question
Last year I had an operation which involved making a four-inch incision down my abdomen. The muscles were split and I am now trying to regain the flat abdomen I once had. Unfortunately the muscles around the scar won't harden. I am left with a nice toned body except for the area around the scar. Will this eventually go back to normal and is there anything I can do to get the muscles to knit back together? It looks quite ugly. Hope you can help.

answer
The incision you describe as ‘down’ does seem to indicate that the muscles were actually ‘parted’ below the skin incision line in order to gain access to the abdominal cavity. This action does tend to weaken the supporting muscle body in an area that is, by the very position, under a lot of pressure.

The abdominal contents, the mechanism of breathing, etc., do tend to put increased strain on the overlying muscles sheets. It is also very common to get incisional herniae developing in this region because of this constant pressure. (There is a bulging of the abdominal lining, and, when fully formed, the abdominal contents protrude through the weakened scar line via a gaping area between the split stomach muscle.) Check with your doctor that this is not happening in your case, as surgical repair would be the only treatment if this has occurred.

The fact that you have a nice toned body seems to indicate that your muscles are in a healthy state generally. A small, isolated ‘bulge’ will certainly indicate the mechanism of pressure, and you will not be able to flatten an area so produced by any amount of muscle exercise.

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