Healing Scars after Plastic Surgery
A common concern among patients is having a noticeable scar after a procedure. Plastic surgery procedures will usually involve incisions in the skin and any injury to the skin will result in visible scars. This is just how the body heals. The good news is that plastic surgeons know where to place the scars to make them less noticeable. Most people will heal their incisions well. Some people, however, can have some scar problems due to local issues such as delayed healing, superficial infection, or poor post-operative wound care. And there are some who are genetically predisposed to large, protuberant scars called keloids.
How does the body heal wounds?
There are three phases of wound healing, each with its own function and appearance. The first is the inflammatory phase. In the first few days after your procedure, the wound will look swollen and red and can be sore to the touch. This is due to the appearance of inflammatory cells releasing chemicals to prepare the wound for healing. Over the next 6-8 weeks, the scar is in the proliferative phase. The scar may noticeably increase in size as healing collagen is continually added, increasing the strength of the wound. The last phase is the remodeling phase, lasting anywhere from 4-12 months. You will notice the scar shrink in size as it remodels itself, breaking down the excess healing collagen and replacing it with the permanent collagen.
What can we do to help reduce a scar after plastic surgery?
There are several therapies I have found successful with patients. The first is scar massage; frequent, vigorous massage of the area. During the second phase of wound healing, the new scar tissue is immature and with adequate massage therapy you can prevent this scar tissue from becoming permanent. That’s right! Simply rubbing a scar can improve its appearance. Another effective treatment is Silicone Sheeting, the most clinically studied option. A silicone scar sheet, lined on one side with silicone gel, is placed directly over the scar. The silicone works to relieve redness, pain, and itching while improving the overall appearance of the scar.
Finally, there is always a possibility that a scar will require injection of steroids or a surgical procedure to improve its quality. This is most common after traumatic injuries, even those immediately repaired by a plastic surgeon, often due to poor location of the wound. As mentioned previously, the position or alignment of the scar on the body greatly influences the acceptability of it’s appearance. Some scars will respond to steroid injections, but this treatment carries the possibility of depigmentation and scar spreading. Others will require a surgical revision to either change the position or alignment, also with its own specific risks.
But don’t be discouraged. In elective cosmetic surgery, preoperative planning allows us to place scars in the most inconspicuous positions. These wounds also tend to heal most favorably due to the ideal conditions under which they are placed. Best of all, you will know the exact location prior to your surgery. Remember, scarring is only one consideration when you are thinking about a cosmetic procedure. Only a detailed consultation with a plastic surgeon can help you make an informed decision regarding the suitability of any procedure.