Treating Scar Formations

Scars and scar formation are some of the most commonly misunderstood medical concepts. If a person undergoes surgery, for cosmetic reasons or otherwise, having a scar is one of the things they should expect. Most patients assume if the operation was performed by a plastic surgeon, there won’t be any scarring. Scars always form but some surgeons are better than others at hiding them.

Scarring is the body’s way of healing itself after an injury. In fact, it is the final phase of the body’s wound healing process. A scar is a direct result of damage from accidents, burns, skin conditions, surgery and trauma. Something as simple as having piercings in your body can cause scars to form.

The body’s wound healing process comes in multiple stages. The first phase involves the sealing of the wound by blood clots to prevent further blood loss and infection. This is followed by a series of events that lead to the formation of collagen to actually repair and fully heal the wound. Wounds that are left to heal on their own produce scars that are a bit worse than those which are closed through stitches. It can take at least a year for a scar to completely heal. Once healed, a scar may appear as a fine line that is minimally visible or as a thick scar like hypertrophic scars and keloids.

Scars are treated using various methods. The choice of treatment depends on how thick and big the scar is. Small and soft scars are best managed by massaging them with moisturizer once or twice a day for a few minutes. The moisturizer should contain ingredients like vitamin E and cocoa butter for maximum results. Sun exposure must also be avoided as much as possible to keep the scars from turning dark. On the other hand, thicker and more extensive scars such as hypertrophic scars, keloids and burn scars can heal properly by using silicone gel sheets.

In recent years, steroids have also been prescribed as a treatment for scaring. Topical steroids alone, or in combination with other scar treatment products, have been proven to improve scar formation in some patients. Steroids administered through injections are said to be effective on hypertrophic scars and keloids. A series of injections is required when using steroids in intervals ranging from six to eight weeks. The most common side effect of injected steroids is the formation of a dent on the site where it is administered. Steroids may be combined with surgical excision especially in cases involving keloids. This combination treatment is usually effective although there is still a possibility for recurrence.

If the treatments listed above fail to produce any response, the patient may try a less common treatment option like radiation therapy. Stubborn keloids respond well to low-dose radiation following surgical treatment. Radiation therapy does raise some concerns due to the risk of long-term complications. Laser treatment is another option but the results vary and some patients find using lasers to be an ineffective treatment.

Scarring should be expected by a patient no matter what type of plastic surgery procedure they are having performed. The key to effectively managing the lasting effects of a scar is knowing how to treat and minimize the long-term effects of any scar formations.

Do’s and Dont’s of Reducing Scars

Scars are made up of the protein collagen which is found in the second layer of your skin. When the integrity of the skin is compromised through injury beyond a superficial this layer must repair itself. It is in the body’s only healing process that scarring takes place.

The key to preventing scars is to break up the collagen that collects in the dermal tissue during the healing process. When the collagen does not bond to your skin’s top layer scar formation is reduced.
It is possible to lighten and revision an old scar, your best approach is to limit scars before they form.

DON’T

DON’T Use Hydrogen Peroxide: While the solution cleans, it also destroys new skin cells that immediately begin to grow in the wound. This slows down the healing process and increased the risk of scars forming.

DON’T Treat with Vitamin E. Recent studies show that it, like hydrogen peroxide, vitamin E impairs healing. One-third of people will also develop an allergic reaction to vitamin E.

DON’T Expose To Sun: Ultraviolet rays slow the healing process and can discolor the scar. The sun stimulates the cells that produce pigment, and when your skin is sensitive and healing, it’s prone to discoloration. Cover the wounded skin with a minimum SPF blocker of higher than 15.

DO

DO Cover A Cut: Should a cut “breathe,” or does it require a Band-Aid over it? When you don’t cover a cut, it dries out and scabs over. Scabbing is not a good thing; it only presents a barrier to healing. Treating cuts with Neosporin (or another antibiotic cream) and covering with a band-aid for a week in aids the healing and prevents infections and minor skin wounds. Do this until new skin begins to grow.

DO Place Pressure On Cut:Use special pads that serve to flatten scars. These scars don’t allow the collagen to pop up above the skin when a wound is healing. Some examples of these pads are: Curad Scar Therapy Cosmetic Pads, ReJuveness Pure Silicone Sheeting, Scar Fx and Sypres Scar Sheets.

DO Massage The Wound: Once new skin has grown, massage the mark. Massaging helps break down the dense bonds of collagen. If they are not allowed to take hold, the appearance of the scar will be much less noticeable, or may not form at all. Massage – with lotion – in a circular motion for 15 to 30 seconds a few times a day.

Scar Revision from Breast Augmentation

All surgeries are going to leave a scar. The leading cosmetic surgeons who specialize in breast augmentation are good at reducing the visibility of the scar. The very best surgeons make sure only very close scrutiny reveal the signature of their work. The techniques for revising scars very and are applied as the surgeon deems best for the patient and their particular case. Often women undergo more than one breast implant surgery. If a woman has suffered from a poor elective procedure the top cosmetic doctors can redo the surgery and also revise the scarring in the same procedure.

Do breast implants last a lifetime? Women considering breast augmentation ask this question frequently. Breast implants are not made with an expiration date, so you should be able to enjoy the results for many years. However, unexpected issues occur for a certain number of patients. If you think you’re experiencing a problem with your breast implants, call us to schedule a consultation and Dr. Hess will see you as soon as possible.

Reasons for Revision Breast Augmentation
Problems that occur after breast implant surgery. Most often they are corrected with a brief revision surgery. Of course, Some of the reasons women seek revision of breast augmentation are :

  • Breast implant rippling
  • Volume adjustment of saline implants
  • Scar revision procedure
  • Change in implant size preferences
  • Switch from saline to silicone implants
  • Areola size reduction
  • Noticeable breast asymmetry
  • Symmastia
  • Nipple ptosis or sagging
  • Breast implant displacement
  • Breast implant rupture
  • Nipple malposition
  • Scar tissue surrounding implant
  • High riding implants
  • Risk of Scar Revision

    Pre & Post Operative Risk of Scar Revision

    Cosmetic procedures involve the placement of scars in inconspicuous areas heal with minimal scarring. Any time an incision is made, a scar will result. Unfortunately, the thickness and the texture of the scar is only partially related to the skill of the surgeon and the procedure itself. In no case will scar revision surgery eliminate a scar completely. In nearly all cases, it will minimize the scar. In very rare cases, the scar could be made worse. This is a risk that a patient needs to accept. The doctor’s knowledge of your healing history is critical to making the most educated decision for the benefit of the patient.
    In developed countries risk in surgery has greatly been diminished. However, a person considering elective scar revision surgery as with any surgery should discuss risks with their surgeon. Here is a partial list a person can ask their doctor about.

    Scar Revision Surgery Risk

    • Allergies (tape, suture materials,blood products, topicals, injected agents etc…
    • Anesthesia Options & risks
    • Changes in skin sensation post-surgery
    • Excessive Bleeding (hematoma)
    • Delayed or Slower healing
    • Deeper Tissue damage e.g. nerves, blood vessels, muscles and lung
    • Pain tolerance or changes to pain sensitivity
    • Possibility of revisional surgery or staged procedures
    • Post-Surgery Infection
    • Skin contour irregularities
    • Skin discoloration and swelling
    • Temporary or permanent damage possibilities

    Take the time to ask questions!. It’s natural to feel some anxiety, whether it’s excitement for your anticipated new look or a bit of preoperative stress.

    The Nature of Scars

    Scars are the result of our natural biological process of wound healing. This repairing takes place in the skin and in other body tissues. The external scars of the skin most often comes to mind even though injured internal parts of the body can heal with scar tissue. Often a doctor can diagnose a condition based on some internal scarring of an organ such as the liver, lungs or kidneys.

    Regenrative Animals do not scar

    What Are Scars?

    Scars are areas of fibrous tissue (fibrosis) that replaces normal skin or organ tissue after injury. This is why it is said that scarring is a normal part of the healing process. Every wound (e.g. after accident, disease, or surgery) has some degree of scarring. There are some exceptions to this in the animal world. These animals undergo regeneration, which do not form scars and the tissue will grow back exactly as before. Some examples are:

    Lizards who lose all or part of their tails can grow new ones. Most
    lizards can regrow a tail within nine months.

    Planarians are flat worms. If cut into pieces, each piece can grow
    into a new worm.

    Sea cucumbers have bodies that can grow to be three feet long. If
    cut into pieces, each one can become a new sea cucumber.

    Sharks continually replace lost teeth. They can grow as many as
    24,000 teeth in a lifetime.

    Spiders can regrow missing legs or parts of legs.

    Sponges can be divided. In that case, the cells of the sponge will
    regrow and combine exactly as before.

    Starfish that lose arms can grow new ones; sometimes an entire
    animal can grow from a single lost arm.

    As mammals, humans just aren’t that fortunate. Scars are part of our existence for better or worse.

    Variant Formation of Scars

    • Scar tissue is the same protein (collagen) as the tissue that it
    replaces, but the fiber composition of the protein is different;
    instead of a random basket weave formation of the collagen fibers
    found in normal tissue
    • Scar tissue is fibrosis and the collagen cross-links forms a
    pronounced alignment in a single direction.

    Scar Tissue has inferior functionality

    • Scars in the skin are less resistant to ultraviolet radiation
    • Sweat glands and hair follicles do not grow back within scar tissue
    • A heart attack causes scar formation in the heart muscle, which
    leads to loss of muscular power and possibly heart failure.
    • Bones can be an exception they can heal without any structural or
    functional deterioration.

    Moles and Changes in Skin Should be Monitored

    Mole removal in eyebrow results in modest scarring.
    Mole removal in eyebrow results in modest scarring.

    Skin Moles or Beauty Marks

    A common skin malady is moles. Sometimes they are referred to as beauty marks. Moles cross all ethnicities. They are raised spots or nodules of skin that are usually darker than the surrounding skin. People with fair skin are more susceptible to having moles.

    Moles are typically benign but dermatologists recommend strongly that they should be monitored as changes can be indicative of some pathology such as certain types of skin cancer. When monitoring a mole one should look to observe changes in any of the following: size, shape, color and formation.

    This is important because melanoma one of the possible forms of cancers can be fatal. This type of self assessment in some instances are preventative or provide early detection which can be life saving. Melanoma when diagnosed early is often curable.

    People with moles, family history should check there skin once a month for changes according to some dermatologist. Even if you are not known to be at higher risk for melanoma or other forms of skin cancer observing and monitoring changes in ones skin should be followed up with appropriate medical evaluation. Moles in children are not unusual and they may grow or change color as a child grows. This is not usually an indication of skin cancer. Some may even disappear in adolescence.

    Higher Risk Factors:
    • People with a high number of moles with some larger than 1.5 mm are at an increased risk of melanoma.
    • People with fair skin are more likely to have many moles and they are more sensitive to sun exposure.
    • Regular mole checks are necessary on people with these risk factors.

    The palms of the hands and soles of the feet do not grow moles; they can appear anywhere else on the body. In areas frequently exposed to sun they can appear in clusters. Moles that demonstrate no signs of pathology are usually not harmful or medically significant. Still, for cosmetic purposes some people want to have them removed. This can be done by a qualified medical doctor such as a dermatologist. Various methods can be used to remove a mole. The best skin doctors opt for a method that is the least invasive if possible. Cosmetic removal choice is most often done to minimize the scarring particularly in high visibility areas like the face.

    Scar Revision Surgery

    Scar Revision of orbital facial scar.Enhancing your appearance with scar revision surgery

    Several people are unhappy of having scars. Facial scarring is the most affected source of self-consciousness, even though scars may be disturbing anywhere in the body for a person. Facial scar revision is taken in consideration after any cosmetic procedure. Scar revision is a surgical procedure which may greatly improve the appearance of scars and increase one’s self-confidence.

    Scar revision techniques vary. Finding the best technique for the right person would depend on the type of your skin, the individuality of the scar and other factors. Scar revision does not completely remove a scar but minimizes the appearance of it as much as possible.

    Scars are visible markings, the formation or the discoloration on the skin is shown after the complete healing process of a wound. They are unavoidable consequences of minor traumatic injury or surgery. The development of a scar cannot be predictable. Poor healing may cause scars to be obvious, unsightly and have some sort of disfiguration. A wound that heals well can still result in a scar that adversely affects your appearance. Scars may be raised or recessed, may also differ in color or texture from the surrounding healthy tissue or particularly be noticeable due to the size, shape and location.

    Treatment Options

    Based on the degree of the scar and the scar classification the treatments can vary. Treatments may include:

    • Over the counter topical treatments
    • Prescribed topical treatments
    • Minimally invasive dermatological procedures
    • Cosmetic surgical revision with advanced techniques in wound closure

    The one purpose of scar revision surgery is to minimize the scar so that it is more consistent with your surrounding skin tone and texture; basically to reduce the scars visibility. Scar revision provides a more pleasing cosmetic result to improve scar that has healed poorly. However, they may not be erased completely.

    Rejuveness – A Method for Changing the Appearance Scars

    Changing the Appearance Scars

     Is there any way to change the appearance of scars or make them fade away?

     The leader in treatment options that truly affect the appearance of scars is rejuveness. With our scar treatment we try to completely make the scars imperceptible or reduce the appearance of scars to a minimum.

    Changing the appearance of scars with RejuvenessSilicone Occlusive Sheeting

    Rejuveness is silicone occlusive sheeting that is durable, reusable and soft. This pure silicone sheeting is a medical-grade; it’s manufactured in the USA by expert technical supervision. The Rejuveness is a non-invasive medical device that reduces hypertrophic and keloid scars resulting from surgical procedures, burns, and traumatic events.

    Rejuveness smooth’s, softens, and flattens scars to restore them to a more normal color and texture. When the Rejuveness is used daily as directed, it has the potential to dramatically improve the appearance of the new and old scars. It has been clinically proven that the Rejuveness is effective in the management of hypertrophic and keloid scars and relieves the burning and itching that are characteristics of scarring disorders. It has also been shown to be a success in the prevention of hypertrophic and keloid scar when applied following surgical procedures.

    The mechanism of action by which the product works involves the product’s high affinity for static electricity. Between the Rejuveness sheet and the surface area of the skin where the product is applied, an electrostatic field forms. The electrostatic pull over a prolonged period of time may be the critical factor in the successful reduction of hypertrophic and keloid scars and prevention of scarring disorders.

    This submission is particularly to expand the indication for Rejuveness and further define instances in which Rejuveness may be used. We also propose to illustrate examples of surgeries where Rejuveness may have application, reference to surgical procedures. We also illustrate the point that Rejuveness has shown efficacy in the prevention of scarring disorders when applied following particular procedures. These singular surgeries are sited in attachment #7 pricing sheet examples and are outlined in the indications.