Scar Care McAllen
Scar Care for the Best Looking Scar
Whenever an incision is made, there will be a scar. Consistent with my philosophy of minimal scar breast enhancement, I make every effort to make the smallest possible incisions and to the hide scars for all my surgeries. I also want the scars to heal as nicely as possible. All scars go through a normal evolution while they are healing and maturing during the first 12 months after surgery, and there are things that can be done to optimize the scar’s final appearance. An important part of this is an understanding of how scars heal, so that you know what to expect.
Immediately after your operation, your incision will be covered with the special Hypafix tape. This tape will protect the fresh incision as it begins to heal, prevents the wound edges from separating, and does well in the shower. You may shower the day after surgery, but avoid submersion in water as in bathing, swimming, or hot tubs until at least 2 weeks after surgery until the incisions are fully sealed to avoid infection.
The Hypafix is kept on for 10 to 14 days. During this time the scar enters into the “Proliferative” Phase of wound healing, with the development of new tiny blood vessels, which gives the early scar its dark and reddish color, and the production of immature collagen, which makes the scar thicker. The tensile strength of the scar increases significantly over the first 6 weeks, and the Proliferative Phase of wound healing continues through the first 3 to 4 months, at which point the scar is maximally red and thick. During this time, I do not recommend getting your scars lasered to eliminate the redness (although I do recommend the 1540-nm non-ablative fractional laser to optimize your scar’s appearance once it’s entered the “Maturation Phase” – see below).
The redness of immature scars is caused by the extra blood supply that your body brings to heal the scar, as well as the myofibroblast cells present in the scars, which are the cells responsible for making the scars shrink. If they are lasered away, you prevent your body from optimally shrinking the scar. While the scar is still immature and red, I do recommend the use of sun block (SPF 30) on the scar. If you get a tan on an immature scar, the pigment will get trapped and make the scar more visible for the rest of your life. Once the scar is mature and white, you do not need to worry about sunblock.
Beginning as early as 2 weeks after surgery once the incisions are fully sealed, silicone over the incisions is the only therapy proven to help scars flatten. Silicone can be applied as a gel 2 to 3 times daily, which dries and leaves a thin layer, such as Kelo-cote®. For longer scars as with breast lift or Tummy Tuck, I recommend using silicone sheets, which can be cut to the shape of the scar and which last longer than the gels. These are available at CVS and H.E.B, their brand is called “Scar Treatment,” “Silicone Scar Sheets,” “ScarAway” and also online is the NewGel version from NewMedical. They have template sheets that work well for a variety of incision types. In order for the silicone sheets to be effective they should be worn for 12 hours per day for 8 weeks. The sheets should be removed to shower, and they can be re-applied for continued use for 3 days, and then changed out for a new sheet. Some patients prefer the Mederma scar cream, which is available at most pharmacies and which also comes with SPF.
After the first 3 to 4 months, the scar enters the “Maturation Phase” of wound healing, which lasts the next 8 to 9 months. During this time the immature collagen produced during the Proliferation Phase matures, and the scar remodels. The scar becomes thinner and the redness fades. I will examine your scars as part of your follow-up visits to ensure they are healing properly and are not turning into hypertrophic scars (too thick). Unfortunately, we cannot control our genetic tendency to form hypertrophic scars, and Hispanic patients have a higher tendency than Caucasians to form hypertrophic scars. If we find your scar is becoming too thick and hypertrophic, then I will recommend some Kenalog steroid injections into the scar, which I will perform at your follow-up visits and which will help thin and flatten the scar.
Once the scar enters the Maturation Phase, the 1540-nm non-ablative fractional laser can be used to further improve the result. This is the only laser approved by the FDA to improve the appearance of scars and stretch marks. Although no laser can “erase” a scar, the 1540-nm laser triggers collagen remodeling to effectively blend the scar into the surrounding, healthy skin, and significantly improves the appearance of scars. Most patients need 2 to 4 treatments in order to achieve the desired results, and there is no downtime. Click here for more information regarding the 1540-nm fractional laser.
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