There are many techniques to perform gastric bypass surgery. Traditionally, surgery used to be performed by giving a large abdominal wall incision. However, considering the healing time and cosmetic concerns of patients, over time, this surgery has evolved into newer procedures. Now doctors can perform surgery with a minimalistic approach. You may find yourself with no visible scars left after surgery.

How will your scars  look like after gastric bypass?

It depends on how your gastric bypass is performed. There are three ways used to perform gastric bypass:

• Single Incision Laparoscopic Surgery: The scar is virtually not visible, as it eventually blends in with the belly button.
• Multi-Port Laparoscopic or Robotic Surgery: the most common approach - 4 or 5 small incisions are made to perform the surgery.
• Open Surgery - a large midline abdominal wall scar: nowadays it is only done if anything goes wrong during surgery.

Single Incision Laparoscopic Gastric Bypass Scars

Cosmetically speaking, single incision laparoscopic surgery is virtually scarless. It offers the best results on your stomach skin. It has minimal invasiveness and quick recovery. However, not all bariatric surgeons perform it, as it requires specific equipment and expertise. This approach also increases the risk for umbilical hernia.

It is performed by giving about an inch size of the incision on your belly button. This incision will be used as a port to insert a camera and tools to perform surgery.

Multiport Laparoscopic or Robotic Gastric Bypass Scars

Laparoscopic surgery became popular in the late 20th century. It offered minimal invasiveness and quick recovery times. Multiport laparoscopic surgery is the most common approach in the US at this time. The robotic minimally invasive surgery is emerging and increasing in popularity.

Generally, one incision is made over the belly button to insert the camera. 3 to 5 incisions are made in the upper and middle abdomen to insert the tools to perform surgery. All incisions are about an inch or smaller.

The scars usually heal with time. Although scars become less visible over a couple of years, they may appear slightly darker than the skin.

Open Surgery (Laparotomy) Gastric Bypass

When gastric bypass surgery was first introduced, it was performed by an open technique. A large incision is given above and below the belly button. It leaves the worst scar and has a high complication rate. It is no longer performed as a first choice unless there is an emergency.

Why Gastric Bypass Scars Occur

Whenever an injury occurs, scarring is the body’s way to heal it. Since giving incision for surgery is a kind of cut injury, our immune system brings in new cells to repair it.

1. At the start, clotting occurs that prevents bleeding.
2. Then white blood cells remove the dead tissue.
3. New cells are brought in that release collagen and form a scab.
4. Over time, this scab fills with healthy collagen, turning into mature scar tissue.

So, scarring is good as it is filling the wound with new tissue. However, it leaves a permanent mark that leaves a cosmetic burden. To minimize the scarring, doctors utilize various techniques like giving the incision along skin tension lines.

Abnormal Gastric Bypass Scars After Surgery

Usually, after scarring completes, our body signals to stop further scarring. If there is an error in that signal, scarring goes on, leading to the formation of extra tissue. There are two types of abnormal scarring:

• Hypertrophic Scar-Extra scar tissue within the wound. It appears darker and thickened within the scar.
• Keloids- Excessive scar tissue going beyond the wound. It looks like extra growth of the tissue. It occurs in people who have a genetic tendency to form keloids.

How to Minimize Gastric Bypass Scars after Surgery

With adequate care and following these proven tips, you can minimize the risk of scarring.

• Follow your bariatric surgeons’ recommendations:

1. Proper wound care
2. Keep the wound clean and dry
3. Use sterile dressings
4. Don’t pick off the scab
5. Gently dry it, don’t rub it

• Take proper nutrition. Your body requires calories to make new tissue. Good diets promote healing.
  Exercise increases blood flow and promotes healing. However, do not overwork as it can stretch the wound and delay healing.
• Avoid smoking. Smoking reduces the oxygen at the wound and delays healing.
• Take plenty of rest and sleep.
• Avoid sun exposure or use sunscreens. Sun exposure causes the scar to darken and thicken.
• Contact your doctor immediately if your wound shows the following signs of infection.

1. Change in color to red
2. Increase in pain
3. More discharge or yellow pus

Bottom Line

• Single-incision laparoscopic gastric bypass surgery offers the best results with an almost invisible scar. However, multiport laparoscopic surgery also provides excellent results with small scars.
• Scarring is normal. You can minimize it by following the tips mentioned above, but you can't guarantee preventing it.
• Try to find a minimally invasive gastric bypass bariatric surgeon to get the best results.