Surgical Scars After Plastic Surgery

Minimizing the Appearance of Surgical Scars After Plastic Surgery

August 17, 2022

You expect to have scars after reconstruction surgery following weight loss. However, there are ways at minimizing the appearance of surgical scars after plastic surgery.

Plastic surgeons offer scar treatment that can help. You may find it reassuring to learn more about your options for scar revision and what you can expect following your surgery.

Scar Maturation

After surgery, the appearance of the resulting scars might be unsettling at first. Please understand, every scar goes through a maturation process that can take as long as two years to complete.

In short, what you see at the beginning of the healing process is not what the scar will look like forever. It will change as the collagen changes from type three to type one. During normal healing, collagen fibers are rebuilt, and scars will experience fading and flattening.

However, not everyone’s scars heal the same, and sometimes there are variations to normal healing.

Hypertrophic Scarring

Sometimes scars become thick and raised as they heal. This is called hypertrophic scarring, which basically means too much scarring. Hypertrophic scarring is an abnormal response to wound healing.

Hypertrophic scarring occurs when additional connective tissue forms in the area of the wound. This type of scar is common when people have surgery.

Keloids

Keloids are similar to hypertrophic scars except that with this type of scarring, connective tissue extends past the area of the original wound. These scars can become quite large.

Keloids are more difficult to treat and may pose an increased cancer risk. Without treatment, keloids will never fade or go away.

Options for Scar Treatment

Fortunately, there are options for scar treatment. The treatment of scars falls into two different categories - passive and active treatment.

The right one for you will depend on your type of scar: normal, hypertrophic, or keloid scar. It may help to understand what to expect when you talk with your plastic surgeon.

Passive Treatment

Passive scar treatments are non-invasive and can work extremely well for patients with scarring following reconstructive surgery. However, optimal scar treatment results depend on adherence and dedication on the part of the patient.

Silicone Cream

Silicone cream can help in a number of ways, such as:

  • Reducing the scar’s size, hardness, and redness.
  • Improving swelling and itching.
  • Preventing a raised scar following surgery.

Silicone creams and gels have shown to be extremely effective. Since silicone creams can easily get wiped off, it is important to reapply as necessary.

Silicone Strips

Silicone strips are another type of topical scar treatment. The strips are thin sheets of silicone that patients wear for 24 hours a day. They are placed over the scar.

The silicone in the strips is able to reach deep layers of the skin. Over time, silicone strips can reduce the appearance of visible scars. Patients using silicone strips may experience:

  • Smoother scars
  • Scars with less color
  • Scars with less elevation

Compression

Compression is another passive form of scar treatment that can reduce scarring and improve the cosmetic appearance of scars. Scar compression is used as a preventative and a corrective method of scar therapy.

Pressure garments are used to prevent hypertrophic and keloid scars from forming. Compression garments can help to improve the rate of scar maturation.

Studies have shown that scars treated with compression exhibit less collagen production, making this a good option for some patients after reconstructive surgery.

Active Treatment

For many patients, even after all the passive treatments mentioned above, scars may still not appear optimal. You may need one of the following active treatment options instead.

Laser Treatment

There are two different types of laser scar treatment. VBeam is for fresh, new, pink scars, and Fraxel is for more mature, non-pink scars.

VBeam works by improving the look and feel of your scars. It targets the deep layers of your skin to stimulate collagen production. Depending on the severity of your scarring, multiple treatments may be needed to achieve the appearance you want.

Fraxel laser treatment works by gently damaging the skin in order to boost the production of collagen. When the skin is slightly damaged, it boosts the body’s own healing process to create new cells and collagen.

Steroid and 5-FU Injection

5-Fluorouracil has been shown to successfully treat hypertrophic scars and keloids; especially when combined with steroid injections.

When injected with 5-FU alone, many patients experienced scar flattening, the resolution of scar pain, and no recurrence of their scars.

Further studies indicate that 5-FU is even more effective with the administration of corticosteroids. This combination can reduce the appearance of scars and lower the chance of recurrence.

Microneedling

Microneedling involves using adjustable needles to penetrate the skin at various depths. The needles form micro-channels, which stimulate collagen production.

The new collagen that is deposited at the site of the scar restructures the skin and as a result, improves the scar’s appearance. After microneedling, many patients find that their scars are softer and smoother with less-defined edges.

Microneedling may yield fast results in some patients. However, results depend on the severity of the scars. Some patients will need microneedling treatment for several months before seeing improvement.

Dermabrasion

Dermabrasion is a type of skin resurfacing that removes the outer layer of skin using a device that rotates rapidly (much like a sander, but medical-grade, of course!). The patients’ skin is either anesthetized or they may be given a sedative.

After dermabrasion, the skin that grows back is smooth in appearance, and scarring is effectively minimized. This procedure requires three to four weeks of healing. Dermabrasion works quite well to help with scarring.

Surgical Scar Revision

There are instances when other forms of scar treatment are not effective. Every patient is different, and for some, surgical scar revision is a necessity.

A scar revision can alter the appearance of a scar, improve scar itchiness, and even restore function to the body that the scar was impeding. In some cases, patients with keloids may require scar revision if other forms of treatment do not work.

Your Plastic Surgeon Provides Treatment For Surgical Scars After Plastic Surgery

If you battle unsightly, itchy, or painful scars, help is available.

Please call a board-certified plastic surgeon to schedule a consultation to determine which method of scar treatment is right for you. They can provide you with several types of treatment, including the passive and active options listed above.

Dr. J. Timothy Katzen specializes in reconstructive plastic surgery

Surgical Scars After Plastic Surgery
timothy katzen

ABOUT THE AUTHOR

Dr. J. Timothy Katzen is certified by the American Board of Plastic Surgery, and is the President of the American Society of Bariatric Plastic Surgeons. Dr. Katzen specializes in reconstructive plastic surgery after massive weight loss. He has written many articles and given lectures around the world about how to perform plastic surgery on patients who have undergone massive weight loss. Dr. Katzen has plastic surgery offices in two different states and two different countries. Specifically, he has offices in Beverly Hills (California), Las Vegas (Nevada), and Dubai (United Arab Emirates). Read more articles from Dr. Katzen!