One of the biggest fears expressed by patients is the appearance of scars after plastic surgery. Unfortunately, we haven’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 closing 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 keloids 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.
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 you scar, 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 therapy program after surgery. This is a must! The main component of this program is silicone. 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 products 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 appearance of your scars there are still many options to improve the appearance. I utilize intense pulsed light (IPL) treatments to remove pigment and redness from the scars. Lasers, 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.
To make an appointment or if you have other questions about scar therapy, make an appointment at our San Francisco office today 415-915-9000.