An appendix scar sits in the lower right side of the abdomen after open surgery, or as two or three small marks (usually one at the belly button) after keyhole surgery. Most appendix scars fade to a thin, pale line within 12 to 18 months. If a scar is raised, widened, indented or puckered, it can often be improved with scar revision once it has fully matured, but a bulge at the scar should be checked by a GP first.
Where the scar is
- Open appendicectomy: a single diagonal or horizontal incision of a few centimetres in the lower right abdomen, often called a gridiron or Lanz incision. Older or complicated operations sometimes left a longer scar.
- Keyhole (laparoscopic) surgery: usually one small cut in or just below the belly button and one or two tiny cuts lower down, often near the bikini line.
- Converted operations: if keyhole surgery was switched to open surgery, you may have both types of scar.
Scars from childhood operations often grow and stretch as the body grows, so an appendix scar from early life may be wider or sit higher than expected.
How an appendix scar heals
For the first few weeks the scar is pink, firm and sometimes lumpy as the deeper stitches dissolve. Over the next few months it may become redder and slightly raised before gradually flattening. By 12 to 18 months most scars are pale, soft and flat. If the appendix had burst or the wound became infected, healing can take longer and the scar is more likely to be wide or indented.
Common concerns
People ask about appendix scars for a range of reasons: a scar that is thick and itchy, one that has stretched into a broad white band, a scar that is stuck down and creates a dip, puckering at the ends, or darker pigmentation. Some notice a patch of numbness nearby, because small skin nerves are cut during the operation; this often improves over time but can be permanent in a small area.
A bulge at the scar
A soft swelling at or near the scar that appears when you cough, strain or stand and disappears when you lie down may be an incisional hernia, where the muscle layer beneath the scar has weakened. See your GP for assessment. If the bulge becomes painful, firm, cannot be pushed back and is associated with vomiting or being unable to pass wind, seek emergency care the same day through A&E, as this can indicate a trapped hernia. Hernias are repaired by general surgeons rather than through cosmetic scar revision.
Improving the scar without surgery
Silicone gel or sheets used for several months can soften and flatten a scar that is still maturing. Firm massage with a plain moisturiser, once the skin has healed, helps with tethering. Protect the scar from the sun with high-factor sunscreen, because a young scar can darken permanently with UV exposure. A thick, itchy scar may respond to a course of steroid injections.
Scar revision for an appendix scar
Once a scar has matured, revision can remove the old scar and re-close the skin in layers to reduce tension, release tethering and tidy puckered ends. Where the scar has been pulled out of line, it can sometimes be redirected to sit more naturally. Revision is typically performed under local anaesthetic as a day-case procedure. The goal is a finer, flatter, less noticeable scar; no revision can remove a scar completely, and the new scar needs another year or so to mature. Find out more on the scar revision page.
Consultation and cost
Mr Nassab will examine the scar, check for signs of a hernia, and discuss what is realistically achievable given your skin type and scar history. Appendix scar revision is from £950 with the final quote confirmed after assessment, and the consultation fee of £150 is separate. Cosmetic scar revision is offered to adults aged 18 and over.
Frequently Asked Questions
How big is an appendix scar?
An open appendicectomy scar is typically a few centimetres long in the lower right abdomen. Keyhole surgery leaves two or three small scars, often less than a centimetre each.
Why is my appendix scar raised years later?
A scar that stays raised may be hypertrophic or keloid. A bulge that comes and goes with coughing may be a hernia and should be checked by a GP.
Can an appendix scar be removed completely?
No. Revision replaces the scar with a new one that aims to be finer and less noticeable.
Will revision be done under local anaesthetic?
Most appendix scar revisions are, as a day-case procedure.
