Any time you have surgery, there is an incision of some sort. Some surgeries use tiny entry points for laparoscopic or simple purse-string procedures, while others require a large open site to get the job done. At any rate, it’s useful to know a bit about how and why scarring occurs, and what can be done to minimize it.
In general, scarring is the skin’s way of repairing itself when it is wounded. Collagen is the protein that lays down lattice-like fibers in the skin, serving as a glue to bind the penetrated tissues back together. Over time, sometimes up to 18 months, this process completes itself through the eventual softening and fading of these mends.
There are several factors that contribute to how one person may scar differently than another. While there are measures that can be taken to decrease the severity of scarring, there are also influences over which we have no control. These include things like age, race, and genetic tendency to scarring.
This is one area where having a few more years under one’s belt may actually be of some benefit! Excessive scarring is often the result of excessive collagen formation, which occurs more before the age of 30 as younger skin has a tendency to over-repair itself. This can lead to what are known as keloids, or raised scars. Additionally, older skin typically has a few more blemishes and age-spots, which help obscure potential scars from being as noticeable.
Race also comes into play as those with darker complexions, such as African-Americans, or those with especially fair skin have a higher likelihood of developing keloids. Regardless of complexion, there are also certain genetic lines of any race that, for whatever reason, just have a greater tendency to scar more severely.
People who are overweight are also more likely to scar because the extra fat tissue under the skin can make it difficult for the surgeon to achieve a seamless reconnection of the incision. This is a big part of why procedures like liposuction or body contouring require patients to be as close to their target weight as possible prior to undergoing surgery.
While these characteristics may suggest an overall higher risk for more severe scarring, they don’t guarantee it, nor are people who don’t share these characteristics necessarily risk-free. There are several ways, however, that everybody can improve the chances that they will heal with less apparent scars to show for it.
First and foremost, it is vital that patients follow the guidance of their surgeon. Invariably, this will mean getting plenty of rest, avoiding certain movements or lifting actions, keeping the incision out of the sun, and staying well nourished and hydrated. Far too often, patients go outside or get back to work earlier than recommended simply because they feel they can, and that it might actually help accelerate the healing if they push through it. This couldn’t be more wrong.
Additionally, patients should avoid fatty and sugary foods that may cause inflammation while making sure to get plenty of protein to help the body repair itself. Drinking alcohol and caffeinated beverages leads to dehydration and should be avoided. Smoking, which inhibits proper blood circulation and pollutes the body, is one of the worst things you can do during the healing process and should be avoided completely.
These precautions aside, there is not a lot of material in the medical community that describes actual treatment for post-operative scarring. Pressure therapy, however, has been shown to be quite helpful in facilitating the healing of incisional scars. These methods utilize silicone sheets and ointments. I am constantly changing my prescriptions on these products, but in general I suggest the use of self-adhesive silicone gel sheets such as Cica-Care by Smith & Nephew. Additionally, gentle massage of the area by yourself or a licensed massage therapist can be useful in helping the new collagen fibers to lay more evenly and prevent scar tissue, especially for deeper incisions. If keloids do form, or if a patient is knowingly prone to keloid formations, I may suggest steroidal injections at the incision site to further minimize them.
Whether large, small, multiple or singular, the healing of incisions can be optimized by following the above suggestions. Through such doing, scars will be greatly minimized and the results of your cosmetic procedures enjoyed for many years to come. Thank you for reading this, and thanks for doing your part!
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