This topic is about dealing with leaks around an ileostomy stoma, specifically when they are caused by indented scars. These indentations can make it difficult for the ostomy appliance to stay secure, leading to leaks, especially when moving or sitting. The person experiencing this issue has tried various adhesive products without success and wants to avoid having surgery to relocate the stoma. Here are some helpful suggestions and insights:

1. Consider consulting a WOC (Wound-Ostomy-Continence) nurse for a professional assessment. Many people have found success after getting a fitting from a specialist.

2. To fill and level the indentations before applying the wafer or pouch:
- Tear or cut Eakin Cohesive Seal rings into smaller pieces or half-moons and press them into the indentations.
- Use Hollister Adapt Paste to fill in the depressions, either by itself or in combination with the ring pieces.
- Combine different techniques: layer Hollister Hollihesive strips in the hollow areas, add a thin coat of paste between layers, then top with a Brava (Coloplast) moldable ring. Finish with a bead of paste around the wafer opening.
- Create a "high spot" by stacking moldable rings directly in the indented area, then apply a ring of paste on the wafer so the materials meld together and eliminate gaps.

3. For larger or multiple recesses:
- Cut an Eakin 4 × 4 sheet or any company's 4 × 4 skin barrier sheet to custom shapes that fill the scars, then apply the pouch over this flat surface.
- Request free 4 × 4 barrier samples from manufacturers to test for thickness and flexibility.

4. As an alternative custom filler:
- After sizing your wafer, save the excess flange material. Cut a strip to fit the indent, secure it with a small dab of paste at the bottom, smooth more paste over the top, then attach the appliance.

5. General tips shared by several people:
- Be prepared for initial applications to take time; speed and consistency will improve with practice.
- Don't disregard "old-school" products if they work for you, even if sales reps suggest otherwise; clinical experience often trumps marketing advice.
- Always "feather" or smooth the edges of the paste to ensure the finished surface is durable, flexible, and less likely to lift.