It is normal to wonder what bariatric surgery scars may look like after gastric sleeve, gastric bypass, SADI-S, duodenal switch, or another weight loss procedure. Most bariatric operations require one or more abdominal incisions, but the number, size, location, and final appearance of the scars depend on the surgical approach and how each patient heals.
Laparoscopic procedures usually leave several small incision marks, while single-incision surgery may leave one less noticeable scar near the belly button. Open surgery generally results in a longer abdominal scar. Most scars fade gradually, but they do not always disappear completely.
Quick Answer: What Do Bariatric Surgery Scars Look Like?
Bariatric surgery scars vary according to the procedure and surgical approach. Laparoscopic surgery performed at Tijuana Bariatric Center commonly leaves several small abdominal scars, while single-incision surgery may leave one scar near the belly button. Open surgery usually creates a longer incision and a more visible scar.
- Laparoscopic surgery: usually leaves several small incision scars.
- Single-incision surgery: may leave one tiny scar near the belly button.
- Open surgery: generally leaves a longer abdominal scar.
- Healing time: scars commonly change in color and appearance over many months.
- Important note: scar appearance varies according to genetics, skin type, wound healing, infection, sun exposure, and aftercare.
Why Do Weight Loss Surgery Scars Occur?
A scar forms as the body repairs skin that has been cut or injured. During healing, the body produces collagen and new tissue to close and strengthen the wound. Early scars may look red, pink, darker, lighter, raised, or swollen.
Over time, many surgical scars become flatter and less noticeable. However, the final appearance varies according to incision size, location, genetics, skin tone, healing time, infection, tension on the wound, and sun exposure.
Where Are Bariatric Surgery Incisions Placed?
The location and number of incisions depend on the procedure, the surgical approach, the patient’s anatomy, previous abdominal surgery, and the surgeon’s medical plan. Many bariatric procedures are performed laparoscopically through several small abdominal access points, although single-incision, robotic, and open approaches may also be used.
Bariatric Surgery Scars by Surgical Approach
| Surgical Approach | Typical Incisions | What Patients May Notice |
|---|---|---|
| Multi-port laparoscopic surgery | Several small abdominal incisions | Small marks across the upper or middle abdomen that may fade over time |
| Single-incision surgery | One access point near or within the belly button | A scar that may be less noticeable depending on healing and placement |
| Robotic bariatric surgery | Several small access points | Scarring may be similar to other minimally invasive approaches |
| Open bariatric surgery | One longer abdominal incision | A larger and generally more visible scar |
The exact number, size, and location of the incisions should be confirmed with the bariatric surgeon before surgery.
Single-Incision Weight Loss Surgery
If your surgeon elects to perform a single-incision surgery near your navel, you'll have virtually no gastric sleeve scar tissue. The lone scar will be in your belly button where no one will notice it.
Multi-Port Laparoscopic Gastric Sleeve Surgery Scars
Patients with gastric sleeve surgery or a gastric bypass procedure will most likely have multi-port laparoscopic surgery. In this case, you will have three to five small scars from incisions placed across your middle and upper abdomen. This technique is quite effective at reducing complications and minimizing scarring.
Open Surgery Scars
Open bariatric surgeries rarely occur, usually only when there is a complication or an emergency. When it does happen, patients generally have a long vertical incision that results in a large scar.
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How Visible Are the Scars?
The scar is hidden inside the navel if single-incision gastric sleeve surgery (SILS) is performed. Therefore, it is not visible at all.
Following traditional laparoscopic gastric sleeve surgery, small scars are somewhat visible. However, they fade significantly over time and become more difficult to see. Open surgery stomach scars often are visible years after the procedure, but open procedures are rarely performed.
Patients will encounter four types of stomach surgery scars:
- Hypertrophic scars that rise above the level of your skin
- Keloids, bumpy scars that go beyond your incisions
- Scars that are larger than necessary, resulting from large wounds or infections
- Discolored, thick scars resulting from sun exposure
How to Minimize Scars From Gastric Sleeve and Other Bariatric Surgeries
You can prevent excessive weight loss surgery scars by following your surgical team's guidelines. These include:
- Caring for incisions properly by allowing them to heal and not picking at the scab
- Keeping surgical sites clean by washing them thoroughly daily with soap and water, then patting them dry with a towel
- Drinking plenty of water to promote healing
- Moisturizing daily to keep the skin soft and supple
- Wearing proper sun protection to protect your skin from UV rays
- Avoiding tobacco, as smoking stunts healing, along with alcohol and caffeine
- Following exercise recommendations, as activity will promote blood flow that will help heal wounds faster and reduce scarring
- Following an appropriate diet per your dietician's instructions, including vitamins and liquid intake, which is crucial toward healing
Sometimes, no matter what you do, you'll have abdominal scarring. Remain aware of danger signs that indicate problems that will ultimately lead to excessive scarring. If your incisions turn bright red or if you see any fluid leaking from them, these signs can indicate an infection, making scarring worse as you may face serious medical issues.
Discuss what you can do to minimize scarring with your surgical team. Options include silicone sheeting or scar-minimizing creams, lotions, ointments, or natural substances like aloe vera or raw honey.
Many products claim to minimize scarring, yet none of them has significant proof or testing that shows the reduction or removal of scars. Silicone gel sheeting can heal small incisions by healing the top layer of skin.
Nevertheless, some patients recommend applying antiseptic spray, triple antibiotic ointment, or Neosporin while the incisions heal. Others indicate you should wash your incisions daily, let them air briefly, and then dress them in gauze and tape.
Among over-the-counter products and other items that patients recommend to minimize scarring include:
- Vitamin E
- Cocoa butter
- Essential oils
- Coconut oil
- Neosporin
- Collagen
- Frankincense
- Laser resurfacing treatments
Internal Gastric Sleeve Scarring
Abdominal adhesions are bands of internal scar tissue that occur after bariatric surgery. They can cause chronic abdominal pain, bowel obstruction and female infertility.
During any bariatric procedure, internal organs are moved around, leading to internal scarring as your organs can stick to each other or abdominal walls. Abdominal adhesions are common, so you should look for the following symptoms after weight loss surgery:
- Intermittent abdominal cramping or severe pain
- Nausea and vomiting
- Inability to pass gas
- Abdominal swelling
- Constipation
- Dehydration
Patients who experience mild abdominal cramping from time to time can often ease this discomfort by going on a liquid diet for 24 hours.
To find out whether you have a bowel obstruction caused by an adhesion, your surgeon will order a CT scan or X-ray of your abdominal cavity. Surgery is the only way to break up the adhesion and fix the blockage.
The best way to avoid abdominal adhesions is by using minimally invasive single-incision laparoscopic surgery or multi-port laparoscopic surgical techniques. They reduce the risk of adhesions by:
- Reducing the risk of blood and blood clotting
- Helping to prevent the organs from drying out by touching the air or surgical gloves
All patients have a different experience when recovering from weight loss surgery, even when minimally invasive techniques are involved. Adhesions forming around incisions are a normal part of healing. Some will disappear in the first few years, while others are noticeably long-term.
Removing Weight Loss Surgery Scars
If your bariatric surgeon uses minimally invasive surgery, you most likely won't have to do anything as the scars fade on their own within the first few months. Most patients find that the tiny incisions leave inconspicuous marks enough not to warrant any treatment.
However, if you are worried about how your stomach looks in that summer swimsuit, you have two options: steroid injections or plastic surgery involving laser resurfacing.
Usually, only scars from open abdominal area procedures will leave cause for concern. Neither steroids nor plastic surgery will remove incision scars from gastric sleeve or other bariatric surgeries altogether, but if you are concerned about your looks, you may want to pursue this route.
FAQs About Bariatric Surgery Scars
Does gastric sleeve surgery leave scars?
Yes. Gastric sleeve surgery requires abdominal incisions. Traditional laparoscopic surgery usually leaves several small scars, while single-incision surgery may leave one less noticeable scar near the belly button.
How many scars does gastric sleeve surgery leave?
The number of scars depends on the surgical technique. Multi-port laparoscopic gastric sleeve commonly uses several abdominal access points, while SILS uses one access point. The surgeon should confirm the expected incision pattern.
Do bariatric surgery scars disappear?
Many scars fade and become less noticeable over time, but they may not disappear completely. Healing varies according to skin type, genetics, incision care, infection, and other factors.
How long do bariatric surgery scars take to fade?
Scars continue changing for many months and may take two years or longer to mature. Some remain visible after that time.
What can help minimize bariatric surgery scars?
Following the surgeon’s wound-care instructions, avoiding tobacco, protecting healed scars from the sun, and discussing silicone products or other treatments with a medical professional may help support healing.
Can bariatric surgery cause internal scar tissue?
Abdominal adhesions can form after abdominal surgery. Many do not cause symptoms, but some may contribute to chronic pain or intestinal obstruction and require medical evaluation.
When should I worry about an incision after bariatric surgery?
Contact the medical team for increasing redness, warmth, swelling, pain, drainage, wound separation, fever, or other worsening symptoms.
