Introduction

As Plastic Surgeons we aim to handle tissue delicately, suture accurately and place incisions in the best possible direction to result in a fine scar. Once these precautions have been taken however, the resulting scar is a matter of each individuals reaction to surgery. Some individuals produce extremely fine scars, others tend to develop hypertrophic (thickened) or even keloid (enlarged) scars. Each individual will form slightly different scars on different areas of the body and at different times in their lives.  The central chest and shoulder areas are renowned for poor scarring and surgeons operate on these areas with great caution.

Is there anything you can do to improve the scarring?

Obviously if a wound becomes infected or a haematoma develops the wound healing can be adversely effected. Smoking decreases the body’s ability to heal and therefore smokers generally produce poorer scars than non smokers. Stopping smoking is an essential consideration prior to any surgical procedure, especially in a non essential, aesthetic procedure.

Supporting the wound with steristrips or Mepore tape improves the scar outcome. There are many oils on the market which claim to improve scarring but few of these have undergone any scientific trials.

Silicone

Silicone has been shown to improve scarring scientifically.  It is thought that this is through hydration.  There are two main methods of applying silicone, either via an ointment form (Dermatix) or using silicone sheets. Newer generation silicone sheets are self adhesive. These can be applied to a wound that is two weeks old and are worn insitu for 12 hours at a time, washing in between.  The silicone sheets are easily cleaned with simple soapy water and therefore can be reused for many weeks.

Avoid Sun Exposure

It used to be said that sun exposure improved scars. Actually the reverse true. In a scar the cells are replicating at a higher rate than normal and therefore their DNA is exposed. Sun exposure is therefore potentially highly detrimental as it could damage the cells during their division. It is therefore recommended to avoid sun exposure until the wounds are mature. If sun exposure is unavoidable then a high factor sun cream should be used.