How Can I Prevent Scarring After Surgery? Scar Care Tips from Dr. Conway
Many of my Asheville plastic surgery patients ask how to prevent scarring after their procedures. Naturally, they want their results to look like a natural part of them, and do not want scars to call attention to the fact that they had a procedure. I want this for them too; as a plastic surgeon, I am trained to consider the location, length, and orientation of incisions to minimize their visibility.
Truthfully, however, scars are unavoidable after any surgery—any incision will heal by forming a scar. But there is good news. You can do a lot to help surgery scars fade significantly, in many cases to the point where they aren’t noticeable to anyone else unless you point them out.
I am sharing with you the scar care tips I share with my own patients. If you are planning to have any type of surgery, elective or not, I encourage you to read them before your procedure, so you can start taking steps for optimal scar care right away.
1. Understand your risk factors from the start so you know what to expect (and how to prevent scarring as much as possible)
Did you know that lifestyle habits and heredity have a significant impact on how scars heal? Some of these factors you can control, some you cannot. Regardless, it’s important to understand your personal risk factors before booking surgery, so you can make changes where possible and enter surgery fully informed:
- Your age. In general, the older you are, the longer it will take for scars to fully heal. However, this isn’t a hard and fast rule; an older patient in excellent health who carefully follows aftercare instructions will often heal better than a younger person who does not.
- Your skin tone. While scars can fade very well on any skin tone, darker-skinned patients are at a higher risk for certain scar complications.
- Your family history. If your family members have had issues with scar complications, you are likely at higher risk of this happening too, although it is not a guarantee.
- Smoking habits. Smoking and tobacco use (including vaping) causes blood vessel constriction, limiting blood flow to healing incisions and slowing the healing process. Smokers are also at higher risk for infection after surgery, which also compromises scar healing. If possible, wait until you have quit smoking for at least a month before undergoing surgery, and refrain from smoking for at least a month after your procedure.
- Your health. Certain chronic conditions, such as diabetes, are associated with poor wound healing. It’s important to be open with your surgeon about your medical history (including all medications and supplements you take) so they can correctly inform you of your risk factors with any surgery.
2. Choose an experienced, board certified surgeon
One advantage that aesthetic plastic surgery patients have is that they can choose any doctor to perform their procedure. Your plastic surgeon’s experience, skill, and technique will have a tremendous impact on what your incisions and resulting scars look like after surgery, so do your research.
First, make sure your surgeon is board certified in plastic surgery; this indicates they have completed years of plastic surgery residency training and have passed rigorous testing proving their expertise. Next, make sure they have experience in the specific procedure you are having. Finally, look closely at their before and after pictures to see how other patients’ scars look after having the procedure you are considering. While yours may heal a little differently, you can expect incisions to be more or less the same length and in the same locations as what you see with previous patients.
If you are undergoing a medically necessary procedure, you may not have the range of choices available in plastic surgery, but it’s still prudent to research surgeons and learn about their training, experience, and reputation before undergoing a procedure.
3. Most important: follow your surgeon’s aftercare instructions
Your surgeon will provide you with a list of instructions to follow after surgery, including instructions for rest and return to activity, bathing and showering, what clothing you can wear, and how to tend to your incisions and drains (if applicable).
These seemingly-lengthy instructions are in place to avoid complications, ensure you heal as intended, and give you the best chance of ending up with least amount of scarring. Ignoring them will put you on the fast track to unappealing scars.
You will receive specific instructions tailored to your unique case, but in general, here are some of the key dos and don’ts:
- Do follow your surgeon’s timeline for activity restriction. Lifting, bending, or even raising your heart rate above a normal walking pace too soon after surgery can strain your incisions, causing them to stretch or widen. Once this happens, it is hard to reverse without a scar revision procedure. Take it easy, and only return to exercise once you are cleared by your surgeon.
- Don’t remove surgical tape or bandages without your surgeon’s express permission. Surgical tape is designed to stay put for days, even weeks. It helps to keep potential infection-causing microbes out of your incisions, and provides mild tension to help incisions heal thin and flat. If surgical tape starts to peel off at the edges, carefully cut away the peeling part with a pair of clean scissors, but do not peel any more off. Alert your surgeon if more than a little comes off.
- Do wear compression garments as instructed. Compression helps to control swelling and support your healing incisions, both of which can help your scars heal in thin lines and prevent them from stretching.
- Don’t pick scabs. It can be difficult, but interrupting your body’s healing response can worsen scars. If healing scars are itchy, talk to your surgeon about safe creams or moisturizers to apply.
- Don’t use scar creams or supplements that haven’t been recommended by your surgeon. Stay on the safe side (and avoid wasting money on bad products) by asking your surgeon for their recommendations.
- Do keep incision sites protected from the sun. Scar tissue is much more sensitive to the sun than normal skin, and can easily and sometimes permanently darken if not protected. Until your incisions have fully closed, keep surgical tape over your incision sites, and keep them well covered by clothing. Once your surgeon says it’s okay, apply a SPF 30 or higher broad-spectrum sunscreen to the site before going outdoors.
- Do be patient. Surgical scars can take up to 2 years to fully fade, and even then there will likely be a faint line left where the incision was made—in many cases, this will only be noticeable upon close scrutiny.
4. If you are concerned about how your scars are healing, talk to your surgeon.
Occasionally, a patient can follow all the rules and still end up with scar complications, such as a hypertrophic scar (characterized by raised, red edges) or a keloid (a raised scar that grows beyond the normal edges). In many cases, darkened or disfigured scars can be treated with laser skin resurfacing or another non-surgical treatment. In more severe cases, such as large keloids, scar revision surgery may be need to remove the scar—yes, a new scar will form, but the intention is to make it smaller and less noticeable.
I hope you have found this information helpful. If you have questions about scar care, scar revision, or plastic surgery in Asheville, I welcome you to contact my office. We enjoy helping patients learn about their options and make confident decisions about plastic surgery.