Some of the most common questions we hear regarding gastric sleeve surgery are: “Will I have bad scarring after gastric sleeve surgery?” and “Will my scars after gastric sleeve surgery be permanent?”. There are no simple answers to these questions because there are many different techniques used for bariatric surgery and advancements in the field are offering less invasive options.
Also, some people are less likely to scar than others depending on their skin type, skin pigmentation, and texture. Here we will highlight the different types of gastric sleeve procedures, and potential scar placements based on incision locations, and offer suggestions to promote healing and scar minimization.
Does Gastric Sleeve Surgery Leave Scars?
It’s likely that gastric sleeve surgery will leave some scarring. Some scarring is unavoidable because our bodies naturally repair wounds by creating scar tissue. Even if performing SILS the least invasive gastric sleeve surgery that utilizes only one incision will most likely leave a small scar. Normally, your surgeon provides information on best practices for healing incisions with the least amount of scarring.
What Causes Scar Tissue After Gastric Sleeve Surgery?
During any surgery that requires an incision, or when you are injured, your white blood cells jump into action and race over to the location of the incision or injury to start fighting infection and healing the area. The body is triggered to begin producing new collagen to help close up and fill the wound area. Normally, a scab will form over the wound to protect it while it finishes the healing job underneath. The scab will eventually fall off leaving new skin and a scar. Our bodies are pretty remarkable!
Do Scars From Gastric Sleeve Surgery Go Away?
Scars that form as a result of gastric sleeve surgery will probably not go away completely. Most scars naturally fade and reduce to a small white line over time, and some of the discolorations on your skin should become almost invisible unless you have had a large incision from open surgery.
Scarring tends to be more pronounced in patients who have higher BMIs, are older, or patients who do not let their incisions heal properly before beginning strenuous activities. Scars from gastric sleeve surgery may be more pronounced and more visible in the following instances:
- A hypertrophic scar has formed (abnormal healing has resulted in a thick raised scar);
- Wounds have reopened due to over-activity or infection complications;
- Sun exposure during the early stages of healing.
What Kind Of Scars Can I Expect After My Gastric Sleeve Surgery?
The scars that result from gastric sleeve surgery will vary depending on the type of surgery performed, the technique used, and how many incisions for the gastric sleeve procedure are needed.
The severity and thickness of scars can be influenced by their location and the surgical instruments used. Laparoscopic single-incision gastric sleeve, multi-port laparoscopic gastric sleeve, and open gastric sleeve surgery will leave varying degrees of scarring.
No-Scar Gastric Sleeve Surgery
Before we dive into all the different types of gastric sleeve surgery and the resulting scars, did you know there is a gastric sleeve procedure that does not leave any scars at all? It is called endoscopic sleeve gastroplasty (ESG) and is performed without using any incisions, so there are no scars. ESG reduces the stomach size by approximately 70% through the use of sutures that are placed in the stomach making it smaller by forming a small sleeve very similar to gastric sleeve surgery. Read our recent FAQs about the endoscopic gastric sleeve to learn more about the procedure.
Scarring From Single-Incision LGS Surgery
Single-incision gastric sleeve surgery is performed through one incision made around the belly button. This is a fairly new approach to gastric sleeve surgery and as such, not all surgeons perform it. Since there is only one incision required for the insertion of a tiny tube, it would only leave one tiny scar, often hidden in the folds of the belly button, virtually undetectable.
Scarring From Traditional Laparoscopic Gastric Sleeve
Laparoscopic gastric sleeve surgery (LGS) is the most common and most frequently performed bariatric procedure. It involves making several small incisions normally around 5 that are used for the surgeon’s instruments to access the stomach through the abdominal wall. The incisions are traditionally made in the upper portion of the abdomen and scarring from the healed gastric sleeve incisions is minimal because the incisions themselves are small.
Scarring From Open Gastric Sleeve Surgery
Gastric sleeve surgery is very rarely performed as open surgery these days. It is invasive and elevates the risks of complications after surgery. In rare instances, it may be necessary such as emergency surgery. The scars that result from open gastric sleeve surgery run the length of the chest vertically from below the breastbone to the navel and are noticeable.
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Timeline for Scar Healing
There are three stages in scar healing, and your scar may look different during each stage.
- The inflammatory stage is stage one and begins immediately when the incision is made or the injury happens. This stage can last three to four days and consists of the construction of blood vessels to stop any blood loss and blood clotting capabilities begin to work. This is also when the white blood cells show up to kill bacteria and clean up the wound. During this stage, your incision will look dark red and swollen.
- The proliferative stage is stage two and begins about day 3 working along with stage 1. Cells called fibroblasts start to produce new collagen and create new blood vessels to repair the damaged tissue. The collagen is being laid down in a disorganized way and this is what causes scars to appear thick and raised at first.
- The remodeling stage is the final stage and starts about 20 days post-incision and can continue for up to a year or more. During this stage, collagen continues to repair and fill in the damaged tissue areas only it does it more systematically and strategically. The collagen around the tension lines aligns and collagen fibers cross-link and lie closer together. This is what causes scars to thin out, lighten up, and become less noticeable.
How Can I Help Heal My Scars Faster?
As a natural part of healing, scars normally become smoother and softer over time (sometimes taking up to 2 years) but there are certain steps we can take to help them heal better and minimize their appearance.
- Keep the incision clean;
- Keep the incision dry;
- Keep the incision covered;
- Avoid smoking;
- Get enough sleep;
- Stay active.
Following the directions from your surgeon regarding your incision after-care will go a long way in helping your post-op gastric sleeve incisions heal faster. Keeping your incisions clean and covered will help deter bacteria from entering the wound and causing infections. Keeping the incision dry will help it heal faster and minimize scarring.
Research has shown that nicotine slows down the healing process of your skin because it reduces the level of oxygen that is carried by your white blood cells to the injured area. The carbon monoxide that is in your bloodstream caused by smoking takes 3 days to dissipate from your bloodstream after you stop smoking and increases the risk of infection.
Getting enough sleep and good circulation are also essential to gastric sleeve incision healing. Faster healing incisions greatly reduce the risks of infection and severe scarring.
Some scarring is inevitable when having surgery but following the aftercare instructions, eating healthy, and getting enough rest helps provide your body with the things it needs to repair itself. If you do end up with visible scarring despite all your efforts, there are several cosmetic treatments that can help minimize or alleviate them. Treatments like microdermabrasion and microneedling, just to name a few, are very effective in reducing the appearance of scars.
Are you considering a gastric sleeve procedure but worried about incisions and scarring? Contact IBI Healthcare Institute today to learn more about the techniques we use, including the scarless gastric sleeve.