One of the biggest fears expressed by patients is the appearance of a scar after plastic surgery. Unfortunately, Sieber Plastic Surgery San Francisco hasn’t yet figured out a way to perform scarless surgery!
Whether you’re having a procedure with tiny incisions like liposuction, or a more involved procedure like a tummy tuck, there are a few different things you can do to make sure you end up with the best scars possible.
What causes scarring?
Skin is a seamless organ, so when there is damage to it, scars form as your body attempts to heal from the trauma. After your procedure, cells called fibroblasts come into the area and lay down new collagen (yes, the same collagen we want in our faces to tighten the skin!) to heal the tissue. Right after the procedure, your body relies on the strength of the sutures used to hold the tissue together. As time goes by and more collagen is placed, your incisions gain more strength and the sutures dissolve and disappear.
Once the scars are formed, your body then goes through and organizes the collagen that was placed. This process can take up to a year, so be patient! Here are the main things which determine how you will scar after surgery:
How well your surgeon closes your incisions
Plastic surgeons are known for their skill for meticulously wound closure incisions. This careful attention to each suture placed will ultimately influence your final result. I make sure to leave you with the best incisions possible before leaving the operating room.
How your body naturally heals
Some people are just blessed with better genetics than others. You probably know by now whether you scar badly or not. Unfortunately, this part of the equation is largely out of your control and is based on the genes you were born with. If you’re someone who forms keloid scars or hypertrophic scars, which form when scar tissue grows excessively, that’s ok because the next section will address other steps which can help improve scarring in everyone.
What you do to care for your incisions after surgery
This is probably the most important sections as it contains information on what YOU can do to improve your scars during plastic surgery recovery.
The MOST important aspect for improving scars is avoiding UV exposure to your incisions for 1 year after your procedure. As the sun contacts your healing skin, the body does not know that the pigment produced is supposed to be there temporarily. What happens is the body builds the pigment procedure within the skin into your scar tissue, leaving you with a dark pigmented scar. That is why it’s extremely important for you to either use a sunscreen with an SPF of at least 30 or keep your incisions covered for the first year. If you’re going to be outside, sunscreen should be reapplied every 2 hours.
All of my patients are placed on a scar treatment therapy program after surgery. This is a must! The main component of this program is silicone topical treatments. Silicone gel and silicone sheeting has been clinically proven to reduce the amount of scarring resulting from incisions. The most basic scar therapy should include at least 3 months of a silicone-based gel which you will apply to your incisions twice daily. I recommend that patients continue using the gel for one year after surgery for the best possible results.
A more advanced scar therapy program utilizes silicone sheets which are first applied two weeks after surgery and left in place for a 12-day cycle. A total of 5 cycles is needed to complete the entire process. Once the silicone sheets are no longer needed I transition patients onto the silicone gel for a total of a 1-year treatment.
Many patients ask about topical treatments like Mederma, Vitamin E, and other creams and lotions. None of these have been scientifically proven to help with minimizing scarring like silicone-based products have so don’t waste your money!
If you’ve already had surgery and don’t like the scar appearance, there are still many options to improve the appearance. I utilize intense pulsed light (IPL) treatments to remove pigment and redness from the scars. Laser therapy, like Halo or Profractional, may also be used to improve scar texture and color. As a last resort, larger scars can be excised and reclosed and using the methods above, you should be left with a finer more inconspicuous scar.
Questions and Answers
What is a Keloid scar?
A keloid results from an overproduction of skin-healing protein, collagen. These scars typically exhibit a raised, uneven texture and develop after the healing of an injury or condition, like a surgical incision or acne scars.
Keloids are generally benign and do not require treatment. However, if someone finds them aesthetically displeasing, a medical professional can sometimes reduce their appearance.
Can plastic surgery get rid of keloid scars?
When nonsurgical treatments fail to address a keloid scar, scar revision treatment may be considered. One surgical approach involves the direct removal of the scar tissue through an incision, followed by the placement of stitches to facilitate wound closure. In certain cases, skin grafts may be utilized to aid in the wound closure process.
What are hypertropic scars?
Hypertrophic scars are a thickened and elevated scar, representing an atypical reaction to the wound healing process, leading to the excess formation of connective tissue within the original injury site. This overgrowth results in the scar being raised. In the typical scenario, minor wounds to the superficial skin layer tend to heal smoothly.
What is the difference between hypertropic and keloid scars?
Hypertrophic scars remain localized to the initial injury site and can, over time, decrease in size. Conversely, keloids extend beyond the original injury boundaries and do not naturally shrink. Microscopic examination reveals that hypertrophic scars typically exhibit an organized, wavy collagen pattern, while keloids lack a distinctive collagen arrangement.
What is scar revision surgery?
Scar revision is a surgical procedure performed to modify the visual characteristics of a scar. The scar revision may enhance the scar’s cosmetic appearance, restore functionality to a previously restricted area of the body due to the scar, or alleviate the discomfort associated with an itchy scar. Scar revision procedures can include skin grafting in some cases.
Book Your Plastic Surgery Consultation Today
To make an appointment or if you have other questions about scar therapy, make an appointment with San Francisco plastic surgeon Dr. Sieber at his office today 415-915-9000.