By Jill Murphy, MD, plastic surgeon at UPMC Altoona Plastic Surgery
“Will there be a scar?”
I get asked that a lot when talking with people about surgery. The truth is, anytime there is a cut through the skin, there is a 100 percent chance of a scar. Surgery always leaves a mark.
While your surgeon’s goal is to make the scar as minimal as possible, many things that influence what a scar will look like. Some of those things are in our control, but there are many other factors that are not.
Contact UPMC Altoona Plastic Surgery or call (814) 947-5030.
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Factors That Affect Scarring
There are a few scarring factors that you and your surgeon cannot control:
Age. Older patients tend to have less prominent scars, which seems counterintuitive since it takes us longer to heal as we age. The scar for an older person is often flat and pale in contrast to incisions in very young people, which may heal faster but are more likely to be thick and pink.
Genetics People with a family history of poor scar formation may be at increased risk themselves. Keloid scars are an especially problematic type of scar that can run in families. Thick and pink, these scars extend beyond the boundaries of the original incision or injury. Keloid scars are very hard to treat. People with a family or personal history of keloid scar formation should put a lot of thought into whether they want to have cosmetic surgery.
Scar placement. Scars often can be hidden on the body in a natural line or fold. Sometimes, however, an incision has to be made in a more prominent location, For example, incisions on the breast bone, over major joints (knees, shoulders), and on the back can be prone to thick, wide scar formation in anyone — even people without a personal or family history of poor scar formation.
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How Your Surgeon Can Help Minimize Scarring After Surgery
Scar placement. Every attempt is made to place your scar in a natural crease or fold, such as the crease beneath your breast during a breast augmentation. When there is no natural crease or fold, the scar can located where it will be easily be hidden by clothes. An example of this is a tummy tuck scar that that can be covered by underwear or a two-piece swimsuit.
Steroids. For scars that are thick and raised, steroids can be injected directly into the scar to soften it or improve its texture. Steroids also can affect the surrounding skin by thinning it out or making it look pale..
Lasers. Lasers can be used improve the color or contour of a scar. Maximum results often take more than one treatment.
Revision. For problem scars that are wide, irregular, or unresponsive to other treatments, a revision may be needed. This involves cutting out the old scar and resuturing the area. Practicing meticulous scar care can help the scar heal better the second time around. Improvement in the scar cannot be guaranteed.
Take Steps to Prevent Scars After Surgery
Scar massage. A couple weeks after surgery you can begin massaging your scar daily. With your fingers, place firm pressure on any area where thick scar tissue can be felt beneath the skin. Massage back and forth and in circles. Do this until the skin on and around the incision feels like your normal, unscarred skin. Be patient. It can take months to see the maximum benefit.
Tape. Taping scars right after surgery can help minimizes the risk of the scar becoming wider. Paper tape from the bandage or first aid section of most stores will do the trick. Taping is most important in the first few weeks after surgery, but can continue for up to eight weeks.
Silicone. Silicone is recommended for minimizing hypertrophic scarring (thick pink scars). Silicone sheets or tape, found in the bandage or first aid section of many stores, can be cut to fit the scar, Remove the silicone before showering and reapply over the scar after washing.
Tension. You should try to avoid putting increased tension on the area over your scar. If there is an incision over your knee, don’t go to the gym to work on squats. The same principle applies to scars on other parts of the body.
Smoking. Nicotine restricts blood flow to an incision and prevents important cells from getting to the area that needs to be healed. To reduce your risk of healing problems, nicotine use (cigarettes, patches, chew, etc.) must be stopped four weeks before and after surgery.
These are just some of the things that can affect healing and scar formation. By focusing on those things that can be controlled, you give your incision the best possible chance to heal with a minimally noticeable scar.
To learn more about this topic, or to schedule an appointment, contact us at UPMC Altoona Plastic Surgery or call (814) 947-5030.
Headquartered in Pittsburgh, UPMC is a world-renowned health care provider and insurer. We operate 40 hospitals and 700 doctors’ offices and outpatient centers, with locations in central and western Pennsylvania, Maryland, New York, and internationally. We employ 4,900 physicians, and we are leaders in clinical care, groundbreaking research, and treatment breakthroughs. U.S. News & World Report consistently ranks UPMC Presbyterian Shadyside as one of the nation’s best hospitals in many specialties and ranks UPMC Children’s Hospital of Pittsburgh on its Honor Roll of America’s Best Children’s Hospitals.