Category Archives: Surgical Scars

Surgery Scars – Steps to Reduce or Prevent Them

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Surgery scars can be reduced or prevented in a variety of ways. If you are planning on having surgery, it is a good idea to understand how to prevent or minimize your scarring. Of course, one of the first things to consider is good incision care. Taking care of your incisions post-procedure is the first step in minimizing long-term scarring.

Surgical Scar Causes

There is the possibility of scarring anytime the skin is damaged. Most of us have a few scars from childhood from skinned knees or elbows. No matter the skill of your surgeon, any surgery results in damage to the skin. A surgical incision causes damage through all of the layers of the skin and can result in scarring no matter where the incision is on the body or what type of surgery is performed. Of course, surgery performed by a less-skilled surgeon can result in greater scarring but, in most cases, the skill of the surgeon has little effect on the amount of long-term scarring. Any surgeon is unable to control all of the multitude of factors that determine your risk for long term scarring.

Surgical Scars how to avoid them

Scarring Risk Factors

Many of the risk factors for scarring are beyond your control. Your ability to heal without scarring depends on factors that cannot be changed. The information below can help you determine your likelihood of post-surgery scarring.

  • Age – The skin becomes less elastic and thinner as we age. The fat layer under the skin thins out and collagen production slows down. When you combine these two facts with sun exposure and other environmental and lifestyle issues, older skin does not heal as quickly or as well as younger skin. There is a silver lining, though – sun damage and uneven tone to older skin can help to hide scars that would be more visible on younger skin.
  • Race – Some skin tones are more likely to scar than others. Keloid scars and hypertrophic scars are much more common with African American patients. With both of these types of scars, there is an overgrowth of scar tissue at the site of an injury. With more fair-skinned races, scars are generally thinner and the color will stay near the color of the surrounding skin. These scars tend to be red or pink when they are new but they will fade with time. Patients with darker skin may experience scars that remain darker than the surrounding skin.
  • Genetics – If your parents have the tendency to scar badly, you will most likely exhibit the same tendency. If you know that you have a family tendency toward scarring heavily, you may want to discuss this with your surgeon ahead of the procedure.
  • Type of Incision – A larger incision is more likely to cause a lasting scar than a smaller incision. The width and the depth of the incision directly affects the length of the healing process and the opportunity for deep scars. Another thing to consider is that a longer incision in the skin may be exposed to more stress with body movements which can delay the healing process in many cases.
  • Skin Healing – Some people are just lucky in that their skin heals quickly and easily with minimal to no lasting scarring. Others are not so lucky and their skin tends to heal more slowly. Sometimes this is due to underlying medical conditions. Having a disease like diabetes can cause your skin to heal more slowly. How quickly the skin heals varies from person to person and can change over time depending on illnesses or current medical conditions.

Scarring Prevention

Even with all of the factors listed above, it is possible to prevent scars by focusing on the factors that you can control. They include:

  • Not Smoking – If you smoke, go ahead and stop as smoking increase the risk of scarring as well as slows down the healing process. Many plastic surgeons will not operate on patients that do not quit smoking for at least two weeks before surgery.
  • Avoid Alcohol – The consumption of alcohol dehydrates your body which causes slower healing. While your incision is healing, you should avoid alcoholic beverages.
  • Stay Hydrated – During the healing process, you should make sure your body is hydrated properly. Dehydration diminishes your overall health and healing can be impacted.
  • Weight Management – Overweight patients are at greater risk of scarring. The fat deposits under the skin can work against the efforts of the doctor to close your incision seamlessly. Watch your weight as much as you can leading up to your procedure.

Scarring and Wound Care

One of the best ways to prevent scarring after surgery is to perform good, consistent incision care. Follow these guidelines:

  • Get plenty of rest
  • Perform incision care consistently
  • Watch for signs of an infection
  • Avoid excessive sun exposure
  • Minimize stress on your incision

Treatments for Scars

There are available treatments for scar minimization that can be performed in the office of a doctor or at home. If you are concerned that you might not heal as well as you would like, consider discussing these treatment options with your surgeon. The doctor can likely recommend options such as silicone wound treatment or prescription medications to help the healing process.

Scar Tissue after Surgery

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People often wonder what their scar is going to look like after surgery. Surgeons can give a general idea of the size, color and appearance of the scar but each person heals differently. According to the National Institutes of Health (NIH), scar tissue is usually thicker than the surrounding skin as well as pink or red in color. However, the appearance of a scar largely depends on the size and depth of the wound. Also, the age of the patient, location of the wound and the time it takes for the wound to heal are all aspects which can influence the look of the scar.

Understanding Scar Tissue

After Surgery ScarsAfter surgery, the body uses its ability to create scar tissue to heal the new wound. However, excess scar tissue beneath the skin can be troubling even after the wound has healed. The tough, fibrous tissue can cause pain and significantly reduce function or range of motion. This decrease in function may transpire due to the direction of the incision and/or the depth of the wound.

For example, bend and straighten the elbow. The folds that form in the skin are known as Langer’s lines. These lines characterize the direction and orientation of the collagen fibers. While making an incision parallel with the Langer lines can happen in some cases, it is not always possible. This is because most surgeries involve cutting into multiple layers of the anatomy. Each layer that is severed must be repaired. As the collagen fibers begin to rebuild, they tend to be erratic and can cause a tightening which can impede some functions. Likewise, surgery on the knees, wrists, shoulder or ankles is often meant to improve movement and function but scar tissue that forms around the joints can create the opposite effect. Frozen shoulder, a condition some patients experience after surgery, is a buildup of scar tissue around the shoulder joints that can cause irritation and inflammation. This can lead to post-surgical pain and impair the range of motion.

Abdominal and Pelvic Adhesions

Abdominal incisions, such as when a person has their appendix removed, can cause abdominal adhesions. Adhesions are bands of tissue which form between the abdominal tissues and the organs. These bands often cause the usual slippery internal tissues and organs to stick together. This can lead to a twisting and pulling of the small or large intestines which create bowel obstruction and chronic pain. Likewise, pelvic adhesions can form after gynecological surgery and cause pain and infertility in some cases. Using certain surgical techniques, such as creating adhesion barriers, can help reduce these pelvic adhesions. Therefore, patients are encouraged to ask their surgeon how they plan to minimize the risk of adhesions.

Scar Prevention and Treatment

Prior to any surgery, patients should ask how much scarring is expected and what type of preventative treatment is recommended. Anytime the patient is undergoing a procedure that involves surgically manipulating a joint area, the surgeon will recommend moving the joints immediately after surgery. This improves function and also helps to prevent excess scar tissue from forming. Patients are always advised to follow post-surgical recommendations and perform targeted exercises to help stretch the skin and guide joints back into the proper position. Massage therapy and ultrasound therapy may also be used to help soften scars and maintain motion after surgery. Although these scar prevention treatments can help to eliminate an accumulation of scar tissue in many patients, some people still develop debilitating scar tissue. Nevertheless, there are numerous scar treatment options which can improve or lessen the appearance of scars and help patients regain motion.

SP

Why Scars Heal Differently on the Body

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Have you ever noticed that you can have scars on different parts of your body and they look dissimilar? When an injury breaches the layer of the skin, the skin cells and blood vessels become damaged and the body sends excess collagen to quickly repair the region. This is the body’s way of forming a barrier to protect it from bacteria and germs. Depending on the amount of collagen sent, it can cause the wound to heal differently and result in scar tissue that looks and feels unlike the rest of the skin. Other factors that impact how a scar heals include:

  • Genetics
  • Age
  • Lifestyle
  • Size and depth of the wound
  • Treatment methods
  • Location of the wound

Abdomen Scar healing process

Here is a rundown of different areas of the body and how scars normally heal in these regions:

  • Knees and Elbows

The knees and elbows are prone to heavy scarring since they are constantly being stretched. Therefore, the skin cannot properly regenerate and heal. The scar tissue may constrict mobility over the joints since the tissue becomes tight and less pliable. Severely limited mobility or pain may require scar revision surgery to improve functionality.

  • Chest and Shoulders

Per the National Institutes of Health, the chest and shoulder regions have the poorest results when it comes to extensive scarring because areas of tension produce thicker scars which appear more noticeable.

  • Legs

Scars tend to be thicker and more prominent on the legs since the skin is normally tighter and tougher than other parts of the body. Scars on the legs are inclined to be hypertrophic scars. Hypertrophic scars can be red in appearance and are raised above the surface of the skin.

  • Abdomen and Stomach

Scars on the abdomen and stomach generally heal well leaving a thinner, flatter scar. Surgical scars can usually be placed below the waistline or bikini line and are rarely seen while wearing everyday clothing. Additionally, this placement keeps the scar protected from the sun for optimal healing and to avoid hyperpigmentation.

  • The Mouth

When it comes to scars, the inside of your mouth is the best at healing. The intraoral tissue stays moist and can regenerate quickly. However, it is critical to keep the area clean to avoid infection. An infection will slow down scar formation and may generate a larger, denser scar.

  • Ears

A scar on the ear is generally thick and more prominent than others. This type of scar is generally a keloid scar. Keloids can be found on any part of the body but are common after an ear piercing. Like hypertrophic scars, keloids are red and raised. Unlike hypertrophic scars, keloids extend beyond the edges of the wound. Keloid scars can be minimized with pressure and topical scar treatments.

Preventing and Treating Scars

To keep scars at bay, you should keep the wound clean and moist until it has healed. Serious burns or deep cuts should be evaluated and treated by a doctor. Post-op instructions should be followed as directed to help minimize scarring. Silicone scar treatments can minimize scarring or reduce scars that have already formed. There are many different types of scar treatments available and each type of scar may respond differently to certain treatments. Consult with your doctor about which treatment might be right for your scar.

SP

Removing Surgery Scars on the Breasts

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Scarring after breast surgery.Patients who had surgery to increase their breast size, reduce their breast size or have undergone a mastectomy will normally see some scarring from the procedure. With most breast augmentation techniques, the scars may not be easily seen due to the fact that they are hidden beneath the bikini line.

Breast surgery incisions are usually made around the nipple, in the armpit or within the inframammary fold. The inframammary fold, or the natural fold below the breast, is the most popular technique as it provides many benefits. However, even incisions made in this region will divulge a scar when lying down. Many prospective patients are not necessarily concerned with the procedure itself but are more worried about the appearance of scars afterward.

Since each person heals differently, how well the skin heals is an important factor for the final appearance and severity of the scar. Even so, there are some methods which can be used to improve or remove scars on the breast.

Silicone gel treatments

Scarring on the breast tissue can be treated with silicone gel treatments. Simply paint the gel mixture onto the scar and leave it on. Some brands of silicone gel treatments are Scar Fade and ScarGuard. Talk to your doctor about what type of gel treatment he or she recommends.

Allium cepa

Scars need hydration to heal and patients can hydrate the scars using an ointment which contains Allium cepa. Allium cepa is extracted from onions and reduces the inflammation and redness of scars. Mederma is one brand of ointment which contains these scar reducing properties.

Rosehip oil

Apply rosehip oil every night before bed by massaging the oil into the scar site. After applying the oil, wear loose clothing to allow the oil to penetrate the skin. Continue this method for 2 to 3 months in order to fade the scar drastically.

SPF

Although scarring from breast surgery is generally covered by a bikini, any visible scarring such as the armpit should be treated with SPF sunscreen whenever going out in the sun. The sun can play a negative role in how noticeable your scars will appear. In addition, the sun can darken a scar long after it heals and this is especially true in people who already have a darker skin tone.

Laser Therapy

At times, scars from breast surgery can heal poorly and undergoing concentrated heat via laser therapy can remove prominent scars. In extreme cases, an additional surgery to excise the scar might be required. Be sure to learn about all the risks and benefits of these procedures beforehand.

Making the decision to have breast augmentation can be an easy one for some people and difficult for others. Patients should talk to their doctor about any concerns and medical issues and also follow all recommended instructions and restrictions. A well informed patient who follows instructions can be the key to a successful breast augmentation procedure as well as any scars healing nicely and being nearly undetectable.

-SP

Scar Treatment and Removal Tips

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Scars are unwanted things that can be a result of surgical procedures, burns, injuries and the removal of moles and acne. Scars develop due to any pull or tension that lasts for too long. Thankfully, there are a variety of methods to help reduce and remove scars.
Cosmetic surgery procedures can remove scars. There are a variety of methods and treatments that can be used to treat and remove scars including:

• A procedure called dermabrasion can lighten scars. An instrument called a wire brush is used to remove the upper layer of skin and, in turn, makes the scar light in appearance.

• Natural remedies used for dealing with scars include the use of lemon, aloe vera gel and onions. These items are rubbed on the scars and left on there for some time. Natural products like lemon, aloe vera and onion possess anti-inflammatory properties that help to reduce skin irritation. They are known to reduce scars and help new skin cells to develop. Natural remedy methods take more time to show their results.

• Silicone gel sheeting is known to reduce scars. It is applied to the affected area and should be used for 3 or 4 months to get rid of scars.

• Steroids are also known to lighten scars. Steroids are injected on the skin that has the scar and converts the raised part of the scar into a flattened one. This procedure takes longer than others to get rid of any scars.

• Laser procedures can be used to remove the upper skin that is affected by scars by making the scar lighter. The laser is also used to activate collagen that helps the new cells to generate and cover the scar.

• Concealers can be used to cover the scar temporarily. In this method, a concealer that matches the skin color is used to cover the scar. It will make the scar invisible for some time.

• Creams can be applied to the scars. If the scar is not very deep, it can lighten up in 3 or 4 months.

• Vitamin E is helpful in dealing with scars by regenerating the skin and redeveloping the treated area. Vitamin E supplements as well as creams and lotions that contain Vitamin E are available at almost any grocery store or drug store. After applying the lotion to the scar, the skin regeneration starts and the scar will disappear within some months depending on the deepness of the scar.

• Dermatologists can apply chemicals on the skin that peel the scar away and allow the new skin to develop. They lighten up the scar and it eventually disappears. Chemical peeling is the name of this method and the chemical used for peeling of the skin is light acid.

• Scrubbing is also a method for treating scars. Exfoliation with a scrub needs to be regularly performed on the scarred area. The scrub must contain alpha hydroxyl acid to help make the scar disappear. The scrubs should be used as directed by a physician after a careful examination of the scar and skin type.

Scars can be lightened, or even removed, by following the steps mentioned above. Sometimes it takes a good amount of time to diminish deep scars depending on the deepness of the scar and the regeneration ability of the skin. A patient should consult with a dermatologist before starting any scar treatments.

Lollipop Breast Lift

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Lollipop IncisionA breast lift surgery, otherwise known as mastopexy, is one of the most commonly performed cosmetic procedures for the breast. Women find it an effective method of restoring the youthful appearance of their breasts. By adjusting the position of the breasts into a higher position, this procedure reduces sagging and makes the curves of the upper body look more defined.

There are many reasons why women want to undergo a breast lift. Some do it because they want tighter and fuller-looking breasts while others are simply bothered by sagging. Sagging of the breasts is usually a result of the aging process as well as giving birth and having children. One thing patients don’t want is the scarring associated with a breast lift. Thankfully, breast lifts are available with different techniques to suit the patient’s needs. One of the most popular among these techniques is the lollipop breast lift which is said to be an excellent compromise between the amount of incisions needed and the effectiveness.

A lollipop breast lift, AKA the vertical lift, is a cosmetic procedure that aims to reshape the breasts without changing its volume. The name “lollipop” is used to describe the incisions used for the procedure. They include a vertical incision that runs from the bottom of the breast to the nipple where a circular incision is made around it. This allows greater flexibility and adaptability while keeping the incisions to a minimum and not as visible as incisions used with other breast lift surgeries. Lollipop breast lift improves the appearance of a droopy breast by allowing it to have a more rounded shaped that looks fuller and more youthful.

Other than a lollipop lift, breast lift surgeries can also be performed using two other incision techniques: Benelli lift and anchor lift.

The Benelli lift, also called the periareolar or donut incision, is performed by creating an incision around the areola only. It is the best option for cases that require very minimal lift.

Inverted T IncisionThe anchor technique, also known as the keyhole or inverted T incision, involves a vertical incision from the nipple down to the bottom of the breast much like a lollipop incision. The second incision is created horizontally and runs along the breast fold, thereby creating a distinctive anchor pattern for which the technique is named.

The lollipop technique offers better results than a Benelli incision. The lollipop can also be performed without the extensive incisions required in an anchor incision. In general, the technique used to perform a breast lift depends on how low the breasts have sagged and how much tissue needs to be repositioned or removed. The lollipop breast lift technique is recommended in cases of mild to moderate sagging that requires a minimal amount of surgical correction. Women in their 30s and 40s who have had children are usually the ideal candidates for a lollipop breast lift.

A lollipop breast lift moderately elevates the nipple, reduces the size of the areola and removes excess skin with less noticeable scarring. The scar fully heals after about six months to one year. Recovery is also faster since the wound created is small. The typical recovery period is only one month.

The results of a lollipop breast lift can last for up to 10 years. The need for a follow-up procedure depends on the size of the breast or if the patient has had implants. For very minimal adjustments, the Benelli lift is usually performed. On the other hand, larger adjustments call for the anchor breast lift.

The lollipop breast lift is one of the most common breast lift procedures. Patients considering a lollipop breast lift should first consult with a plastic surgeon experienced in performing the procedure.

Sometimes Scars Are Not Visible On The Outside

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It’s been estimated that the American public spends more than $12-billion dollars each year on procedures that change, alter and enhance their looks. Physical appearance is such an important component of daily life that a nip here and a tuck there play an important part in the way many people feel about themselves.

A February literature review from the Perelman School of Medicine at the University of Pennsylvania stated that scars resulting from skin cancer surgeries, on areas such as the head and the neck, can alter the psychosocial well-being of a person. In fact, the psychosocial impact of scarring resulting from scan cancer treatments impacts patients regardless of their age and gender. (1)

One technique being employed by doctors to reduce the visibility of scars resulting from skin cancer is the Mohs technique. This medical procedure is a micrographic form of skin cancer removal utilized in cosmetically sensitive areas like the face and hands. The Mohs technique allows doctors to pinpoint the cancer and remove a small amount of normal skin that surrounds the cancer. The end result can be virtually unnoticeable scars following surgery.

According to Joseph F. Sobanko, MD, director of Dermatologic Surgery Education, and an assistant professor of Dermatology at the Hospital of the University of Pennsylvania, the way patients feel about themselves can be greatly influenced by their final cosmetic look after surgery.

According to Sobanko, “What we’re learning now is that these scars are much more than skin deep, and given these possible repercussions, it’s vital that surgeons be able to provide patients with advanced treatment options to limit and avoid visible scarring.” (2)

While it’s sometimes hard to implement this practice in daily life, it’s important not to judge a person solely on their physical appearance. The scars on their outer appearance might be nothing compared to the scars they are feeling inside.

(1)http://www.ncbi.nlm.nih.gov/pubmed/25654193
(2)http://news.pennmedicine.org/blog/2015/05/beyond-skin-deep-how-scars-affect-psychosocial-well-being.html

Z-plasty for Scar Revison

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Z-plasty is now being considered as a standard practice for scar revision. With doctors’ offices all over the world now using this technique, one would be hard pressed to find a different technique when it comes to camouflaging scars. This technique has been around for a century and yet, many people fail to realize how it works.

A Z-plasty works like this, at the end lengths of the scar, incision are placed horizontally so that the new incisions and the original wound/incision together form a Z. Once incised, the flaps of the flesh are sutured over and used to cover the wound overall, giving new less tense give to the skin in smaller units, and setting the transposed skin into overlapping “flaps” where their final positions are a three layered triangular fix.

This irregularity of wound closure causes a smaller, united scar that is less noticeable type of scarring that is better camouflaged than the straight line easily hyper-pigmented versions of incisions. This general realignment of the incisions can make for a better visual to surgery wounds.

The only other techniques that are comparable to a Z-plasty would be a W-plasty. A W-plasty, although slightly different, is just a variation of the Z-plasty technique, operating on the same basic principle of relieving overall tension on sutures and skin wounds to allow for a better healing process.

What is Partial Trichophytic Closure?

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Trichophytic closure is a type of scar closure that is used in conjunction to a hair restoration. For many years, trichophytic closure has been used for scalp surgeries allowing hair to grow into the scar, improving the appearance. When hair is introduced into the scalp scar, it helps reduce the contrast of the scar and the hair area. Trichophytic closure can be done on the upper edge, lower edge, and double edge of the scar.

Partial Trichophytic ClosureScar tissue and the transection of the lower portion of hair follicles, on the edge of the scar, are what cause the lack of hair in the scar. Partial trichophytic closure, recently introduced by Dr. Parsa Mohebi, requires the hair transplant surgeon to observe the donor wound edges and calculate the width of the edge that needs to be removed at any area. The surgeon will use magnifying loupes in order to carefully observe the edges of the wound, making sure that there is no transection in the hair follicles.

Partial trichophytic closure assures that hair will grow into the scar from the upper edge in order to minimize the contrast between the scar and the surrounding hair areas. With this method the visibility of the donor scar is minimized drastically if done properly.

What is a Scar?

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Many of us will have the experience of getting scars, but some may wonder what is a scar? Scars occur when the skin starts to heal itself. Once the upper layer of the skin is damaged, a person’s body begins to form collagen fibers to close the wound. Once the wound is completely healed, scars will begin to form. There are many factors that can cause scars to form different shapes and colors.

Pale scarScars start off by appearing red in color, which is when the blood vessels are inflamed and damaged. This part is known as hyper pigmented scars. Once a scar matures, the skin pigment will be lost and the color will change to white, which is known as hypo pigmented. Scars take approximately six to twelve months to completely heal and become white. The size, shape, and depth of the scar are all factors that contribute to how the scar will look after completely healing. In order to prevent darker scarring and infection, it is important to always keep the scar area clean and moist, during the healing process.

Although you can never get rid of scars, there are many treatment options now that can help to camouflage the look of the scar. Some types of treatments are topical creams, surgery, dermabrasion, steroid injections, laser resurfacing, and filler injections. Depending on where your scar is located and the size of the scar, your doctor can recommend you to try one of the treatments.