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During healing, the scar can adhere to the fascia or muscle layer beneath it, tethering the overlying skin downward and creating a protrusion or ledge of skin and fat above the scar line

5.2 Disorders of mitochondrial long-chain fatty acid oxidation 5.2.1 Very long-chain acyl-CoA dehydrogenase (VLCAD) deficiency Clinical presentation Patients diagnosed with VLCAD deficiency (OMIM 201475) can suffer from hepatic, cardiac and muscular symptoms that can appear in infancy, but also later during adolescence or adulthood

An alternative would be to investigate the effects of periodic flushing with a bolus of oral Neu5Ac

doi: 10.1371/journal.pbio.1002533 20 BelizrioJEFaintuchJ