If you want get rid of stretch marks, you likely won’t undergo an actual surgery. And even if you choose to, stretch marks can never be fully removed. Three board-certified plastic surgeons explain.

By Emily Shiffer
October 22, 2019
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For many women, stretch marks are part of life, whether they appear during puberty, pregnancy, or on a weight-loss journey. So it's no wonder there are so many women out there searching for ways to get rid of them. But is the idea of going under the knife to nix stretch marks really an option?

Let's start by understanding what stretch marks are:

"When the outer layers of the skin weaken, the skin literally stretches in linearly or patchy arrangements. The stretched skin is thinner and more translucent so the color, texture and integrity of the skin appears different than the surrounding normal skin," says David Shafer, MD, FACS, board-certified plastic surgeon in New York City.

In other words, stretch marks are permanent scars under the skin, explains Manish Shah, MD, FACS, board-certified plastic surgeon in Denver, Colorado. And because of that fact, the idea of a stretch mark 'removal' surgery really doesn't exist. There are, however, multiple procedures that help minimize their appearance.

"The purpose of stretch mark treatments are to get the color to fade into the background and to grow collagen in the dermal injury to fill it back up to reduce the appearance of the stretch mark," says Dr. Shah.

Stretch Mark Procedure Options

The best treatment option for you will depend on your Fitzpatrick skin type, a scientific skin type classification based on pigment in your skin. Here the most common methods doctors use to diminish stretch marks, and how they work:

Microneedling

"All patients can tolerate microneedling and radiofrequency microneedling, as these treatments are colorblind and do not really carry any significant risk of pigmentation abnormalities," says Dr. Shah. "They work by making tiny fixed depth injuries in the skin down to 8mm under the skin. These injuries heal quickly and new collagen and elastin form to reconstruct the area. These treatments can be augmented with platelet rich plasma injections (PRP) or nanofat injections for maximum effect."

Fractional laser therapy

"An option that is even more powerful is the use of fractional laser therapy to create the same micro injury. The risk with laser is greater in terms of risk of burn, infections, scarring, and pigmentation abnormalities," says Dr. Shah.

Excisional surgery

"The only surgery for stretch marks would be excisional surgery (cutting the skin containing the stretch marks out). This is really only done in certain situations, particularly where there is significant skin excess," says David Cangello, MD, FACS, board-certified plastic surgeon in New York City. "This is very common with procedures such as tummy tucks or thigh lifts or arm lifts. But it would be very unlikely that an area of skin containing stretch marks was 'cut out' just to remove stretch marks because the resultant surgical scar is not really the best trade off."

Are They Safe? 

This scary story recently made headlines about a woman who was left with infected scars after having a stretch mark removal procedure. But before you freak out, this procedure was not one that was FDA-approved.

"This patient had a plasma pen treatment. As far as I know, this is not an FDA-approved therapy in the U.S. It is high risk for burns and hyperpigmentation/hypopigmentation," says Dr. Shah. "You are essentially using a tiny electrocautery device to create micro burns in the skin that tighten the skin as they heal. This patient suffered burns and subsequent abnormal scarring on her stretch marks."

But overall, these procedures are safe.

"In the hands of properly trained practitioners, these treatments have all been shown to be safe," says Dr. Shah. "Stretch marks are weaker than normal skin and need to be managed more gently to avoid complications."

Stretch Mark Procedure Costs

"Treatment prices will vary from $300-500 for microneedling to several thousand dollars for laser and bio-volumizer injections," says Dr. Shah. "It is important to note that most patients will need multiple treatments to get the best results, and they should budget accordingly."

While they aren't cheap, the good news is that these procedures have a pretty short recovery time. "Most recovery takes less than 1 week, and full results will be seen in 6 months after treatments are completed," says Dr. Shah.

Less-Invasive Stretch Mark Procedure Options

Injectables

"Non-invasive therapies that are showing some promise with reducing the appearance of stretch marks involve the injection of either dilute Sculptra(TM) or Radiesse(TM) into the stretch marks directly," says Dr. Shah. "These two injectable fillers are known as bio-volumizers. Unlike HA fillers (eg. Restylane, Juvederm), these two bio-volumizers leave long-term collagen behind, filling in the damaged dermis."

According to Dr. Shah, these therapies can be used in combination with others.

"I always emphasize that the goal is to reduce and blend out the appearance of the stretch mark," says Dr. Shah. "Combination therapies give the best results because they treat the varying factors involved in the creation of a stretch mark. But, it is always important to remember that they never go away completely."

Medical tattoo

"Sometimes medical tattoo can also be used to help match the color to the surrounding skin," says Dr. Shafer. And you should know that not all products marketed to erase stretch marks work.

"There is no cream or topical that gets rid of stretch marks," says Dr. Cangello. "One that has a retinol would be your best bet because retinols do actually have the ability to stimulate collagen production, but the result, if any, will still be quite limited. Creams containing retinol are good for preparing the skin for laser treatments as they help to potentiate the effects of the laser. This is also true for exfoliant washes."

The Bottom Line

Experts agree none of these treatments will remove stretch marks completely. "The terminology definitely needs to be 'reduce' or 'improve,' and not 'remove'," says Dr. Shafer. "The goal is to improve the color and texture of the skin and tighten the collagen in the skin. It's best to consult with a board certified plastic surgeon for an evaluation."

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