Timing scar revisions

Whenever someone has a surgical incision or traumatic laceration, after the initial suturing, the urge to see a plastic surgeon for better scars after cosmetic surgery is irresistible.

Initial care of a scar

After a traumatic injury or a cosmetic plastic surgery incision, the wound is usually closed with sutures or glued by a plastic surgeon or emergency room doctor. The care of the wound in the initial few days is usually pretty standard. Patients typically apply antibiotic ointment to the wound for a few days after keeping it dry for a couple of days. After suture removal, most plastic surgeons should recommend applying a sunblock and silicone-based cream to smooth out the scars, and then you wait.

Scar healing over time

The patients that come to the plastic surgeon’s office seeking improvement of a scar fall into two groups: those who have had a scar for years and those who have had a scar for only a few days.

For patients with a new scar, all the plastic surgeon can do is hold their hand. The new scar has to go through its normal and expected range of healing phases. Scar formation will reach its peak eight weeks after wound closure, and the swelling may remain for several months more. Only after the scar has reached “maturation” is your plastic surgeon ready to intervene to improve it. Doing so earlier is not advisable unless the scar, as it heals, is pulling or pushing other structures disadvantageously. Usually, you must wait one year for the process of scar maturation. But you can do somethings; silicone creams can help decrease the redness of a scar and also placing paper tape on the scar can give you a better scar.

Scar healing in children

Waiting for a scar revision is always hardest when children are injured.

As parents, we have a feebleness that engulfs our thoughts when it comes to our children and an irrationality that often works against our children’s best interests.

It is actually the most important group of patients to be the most patient with in regards to getting a good scar result. Chidren’s scars typically take up to two years to mature and stop changing in color. They will, however, continue to change in shape and texture for as long as the body grows, and, if given enough food, the child will grow and the scars will stretch and become thinner. Secondary, tertiary and even multiple scar revisions are often necessary on a childhood scar to achieve the best result.

Scar revision

Once the patient has waited for the scar maturation process to complete, which may last a year, scar revision planning can occur. Surgeries may be minor or major, single-step or taking multiple steps, and will inevitably result in another scar that will need… another year to mature. This is why there is a push to minimize scars during surgery, and your board-certified cosmetic plastic surgeon is the best person to place them in the most inconspicuous areas.

Botulinum toxin

One of the lates and most exciting discoveries of 2018 was that a small amount of botulinum toxin injected into either side of a new scar can minimize the chance of hypertrophic scars. This gives further credence to the idea that stretch of muscles and tension on skin is the cause for thick scars.