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WhatsApp UsIf you're reading this, you or someone you love is looking at a scar or feeling a tightness in the buttock area that won't go away — and you're wondering: Is this permanent? Is there anything that can actually fix this?
I've been a plastic and reconstructive surgeon for over 15 years. I trained at Safdarjung Hospital, New Delhi—one of the country's highest-volume reconstructive centers. I've seen contractures from burns, from botched BBLs done in metro cities, from silicone injections gone wrong, and from surgical complications. I've released contractures in children, in young women, and in elderly patients. And I will tell you honestly — there is almost always something we can do.
Think of scar tissue like a rubber band that forms under the skin after an injury or surgery. In most cases, it stretches and softens over time. But sometimes — especially after burns, deep infections, or complex surgeries — the rubber band doesn't soften. It tightens. It pulls the skin inward. It puckers. It dimples. It anchors the skin to the tissue underneath. That is a contracture. The buttocks are particularly vulnerable because: • The skin over the buttocks is thick and under constant tension from sitting, walking, and moving • Burns and grafts in this area heal under constant mechanical stress • Fat injections (BBL, silicone) can cause fibrotic reactions deep under the skin • Poor-quality procedures done in unregulated settings cause far more damage here than anywhere else
Anatomy & Surgical Foundations
- 1. Burns — The Most Common Cause Burns to the buttock and gluteal area — whether from fire, hot water, chemical, or electrical contact — cause deep tissue damage. When the body heals, it produces collagen in overdrive. If that collagen forms incorrectly, it becomes a band of tight fibrous tissue. This is especially common in children who survive scald burns to the back and buttocks. I've treated hundreds of post-burn contracture patients from Krishna, Guntur, West Godavari, and Prakasam districts — many families who didn't even know contracture release surgery was available in Vijayawada and were about to travel to Hyderabad or Chennai.
- 2. Scar Massage and Manual Therapy The simplest and most underused treatment. Deep cross-friction massage breaks down fibrous adhesions, improves blood flow, and softens the scar matrix. It works best when started early (6–8 weeks post-op) and performed consistently. • Best for: Early post-surgical fibrosis, mild tightness post-BBL • Needs: A therapist trained in post-surgical massage — not a spa, a medical-grade therapist • Results: Gradual improvement over 6–12 weeks
If you only read this table, you'll know more than most patients walking into their first consultation.
| Question | Quick Answer |
|---|---|
| What is it? | Tightening, pulling, indentation, or visible scarring of the buttock skin after surgery, burns, BBL, or injections. |
| Is it fixable? | Yes — most contractures and scars respond well to treatment. Early action gives the best results. |
| Who treats it? | Dr. Pratap Duggirala, M.S., M.Ch (Plastic Surgery) — All India 2nd Rank — Vijayawada, AP. |
| Treatments available? | Scar massage, steroid injections, laser, subcision, fat grafting, scar revision surgery. |
| Where in AP? | Pratap Hospital, Vijayawada — serving all of AP, Telangana, and patients from overseas. |
Proper care after burn injury or reconstructive surgery is essential for supporting healing, improving mobility, and minimizing excessive scarring. Following the treating surgeon’s instructions can help reduce complications and support long-term recovery.
✓ Good Candidates
- Follow your surgeon’s instructions: Attend follow-up appointments and follow the recommended wound-care and recovery plan.
- Keep the wound clean and protected: Use the dressings and wound-care products recommended by your healthcare team.
- Participate in rehabilitation: Perform prescribed stretching exercises and physiotherapy to maintain flexibility and improve movement.
- Use splints as directed: If prescribed, wear splints or positioning devices for the recommended duration to help prevent the return of contractures.
- Manage scars appropriately: Once the wound has fully closed, use recommended scar treatments, such as silicone gel or sheets, if suitable for your condition.
- Protect the skin from sunlight: Cover healed scars and use broad-spectrum sunscreen on exposed areas to help reduce discoloration.
- Maintain a balanced diet: Consume adequate protein, vitamins, minerals, and fluids to support tissue repair and overall recovery.
- Monitor changes: Report increasing pain, redness, swelling, wound breakdown, or reduced movement to your healthcare provider.
✕ When to Wait or Reconsider
- Do not ignore wound-care instructions: Avoid changing dressings or applying products that have not been recommended by your care team.
- Do not stretch beyond your prescribed limits: Avoid forceful movements or exercises that cause significant pain or damage healing tissue.
- Do not pick at scars or scabs: Scratching, peeling, or rubbing the area can irritate the skin and delay healing.
- Do not apply unapproved home remedies: Avoid harsh chemicals, household products, or unverified scar treatments.
- Do not use silicone products on open wounds: Scar-management products should generally be used only after the skin has healed and your clinician confirms they are appropriate.
- Do not discontinue splinting or therapy independently: Stopping rehabilitation too early may contribute to stiffness or recurrent contractures.
- Do not expose healing scars to excessive sunlight: UV exposure may worsen pigmentation and make scars more noticeable.
- Do not smoke during recovery: Smoking can impair blood flow and delay wound healing; seek support to stop if needed.
Step 1: Clinical Assessment and Surgical Planning
The surgeon evaluates the scar’s thickness, location, elasticity, and effect on nearby joints, muscles, and skin. Range of motion, skin availability, previous treatments, and the patient’s overall health are assessed to determine the most appropriate treatment plan.
Step 2: Preparation for Surgery
Before surgery, the team reviews the patient’s medical history, previous burn treatments, wound condition, and healing risks. Surgery is generally planned once the burn wound has healed and the patient is medically suitable, although earlier intervention may be necessary in selected cases with severe functional impairment.
Step 3: Scar Release and Contracture Correction
Under appropriate anesthesia, the surgeon carefully releases the contracted scar tissue to improve mobility and relieve tension. The extent of release depends on the scar’s depth and the structures involved, with particular care taken to protect nerves, blood vessels, tendons, and other important tissues.
Step 4: Reconstruction of the Released Area
Once adequate release is achieved, the resulting skin defect is reconstructed using the most suitable technique. Options may include: Z-plasty or other local tissue rearrangement: Redirects scar tension and may improve movement in selected linear contractures. Skin grafting: Uses healthy skin from another body area to cover the released defect. Local or regional flaps: Transfers nearby tissue with its blood supply when additional coverage is required. Tissue expansion or advanced reconstruction: May be considered for selected patients when additional healthy skin is needed.
Step 5: Wound Closure and Dressing
The reconstructed area is carefully closed or secured, and appropriate dressings are applied to protect the wound. Depending on the procedure and the area treated, splints or positioning devices may be used to maintain correction and reduce tension during early healing.
Step 6: Postoperative Care and Rehabilitation
Pain management, wound monitoring, and follow-up appointments help support recovery. Physiotherapy, occupational therapy, stretching, splinting, and guided exercises may be essential—particularly for contractures involving the neck, hands, elbows, knees, or other joints.
Step 7: Scar Management and Long-Term Follow-Up
After the wound has healed sufficiently, the care team may recommend silicone-based scar treatments, pressure garments, moisturization, or other individualized scar-management measures. Regular follow-up helps assess movement, scar maturation, wound healing, and the need for additional treatment. Treatment outcome: Post-burn contracture and scar surgery aims to improve function, comfort, and appearance. Results vary according to scar severity, tissue quality, healing response, and rehabilitation. Some patients may require staged procedures or revision surgery to achieve the best possible outcome.
| Timeline | Expected Sensation | Activity Allowed | Garment Care |
|---|---|---|---|
| 0–4 weeks | Swelling, redness, tenderness, firm tissue under the skin | ||
| 4–8 weeks | Gradual softening of tissue, fading redness | ||
| 8–16 weeks | Scar flattening and fading, improved mobility | ||
| 4–6 months | Scar continues to fade (takes 12–18 months total) | ||
| 6+ months | Mature scar — light, flat, flexible |
The cost of treatment may vary depending on the severity of the burn scars, the complexity of the procedure, and the individual patient’s needs. While exact pricing cannot be confirmed in advance, we strive to offer reasonable and transparent treatment costs tailored to each patient’s requirements.
Want a personalized quote for your specific anatomy?
Get My Itemized QuoteWill my contracture get worse if I don't treat it?
Yes, in most cases. Mature scar tissue (older than 18 months) is harder to treat than early scar tissue. If you're noticing tightness or pulling, the smartest time to act is now — not after waiting to see if it resolves on its own.
Yes, in most cases. Mature scar tissue (older than 18 months) is harder to treat than early scar tissue. If you're noticing tightness or pulling, the smartest time to act is now — not after waiting to see if it resolves on its own.
Absolutely not. I see revision cases every week — from patients who went to unqualified providers, from those who trusted someone they shouldn't have, from people who simply had bad luck with healing. My only job is to help you get the best result from here.
How many sessions will I need?
Depends entirely on the type and severity of the contracture. A mild post-surgical fibrous band might need 3–4 sessions of subcision and PRP. A severe post-burn contracture may need surgical release with skin grafting. I will tell you honestly after I assess you — no vague 'it depends' without a real plan.
Is surgery the only option for severe contractures?
Not always. Some patients I've seen expecting surgery have responded beautifully to a combination of subcision, steroid injections, and laser. We always try the least invasive effective option first unless surgery is clearly necessary.
Can I come from Hyderabad, Bangalore, or the Gulf for this?
Yes, and many patients do. We coordinate pre-consultation via WhatsApp photographs and video call. We plan your surgical date in advance and schedule everything so your time in Vijayawada is used efficiently. We have multiple patients who fly in, have surgery, recover here for 3–5 days, and return home.
What is the cost of contracture release surgery in Vijayawada?
Significantly lower than metro cities for comparable or superior quality. Exact cost depends on the procedure type, anaesthesia, hospital stay, and complexity. During consultation we give you a transparent, itemised estimate — no surprise billing.
How long is the recovery after contracture release surgery?
For minor procedures (subcision, steroid injection): return to normal activity in 3–5 days. For surgical release with skin graft: 3–4 weeks restricted activity, full scar maturation at 12–18 months. We guide you through every stage.
My child has a post-burn contracture. Can you treat children?
Yes. Paediatric burns and contracture management is one of the areas I am most passionate about. Early release prevents long-term deformity, growth restriction, and psychological impact. We are gentle, thorough, and experienced with children of all ages.
Will there be another scar after surgery?
Every surgery leaves some mark — but the goal is a scar that is far less visible, far less tight, and far better placed than what you had. Good scar management post-surgery (silicone, massage, sun protection) dramatically improves the final cosmetic result.
What should I bring to my first consultation?
All previous surgical reports, photographs taken over time showing scar progression, any previous treatment records (injections, laser, cream), and a list of your questions. Come prepared and we'll use every minute well.
"At 52, I hated how my neck looked in photos at family functions. Dr. Pratap performed a neck lift and lipo. The result looks completely natural — friends tell me I look refreshed and energetic."
