Scar Management

Before and During the Operation

Surprisingly there is little scientific evidence on how to avoid problem scarring. We do know that certain skin types and certain areas of the body are more likely to develop hypertrophic or keloid scars. If you are at high risk I will discuss this with you before surgery.

The best way to deal with problem scarring is by prevention. Meticulous technique, tension free repair, use of appropriate sutures and avoiding complications are important factors.

After the Operation

Dressings will be removed in my rooms or with hand therapy. Microporous tape may be applied after removal of sutures. There is little evidence this prevents problem scars but I use it in high-risk cases. It does help camouflage wounds during the early healing phase.

Protecting scars from the sun by using sunscreen, a hat and covering, help prevent pigmentation changes.

After Wound Healing

Firm massage with moisturising cream, gel or ointment, in a circular pattern, is recommended 3 times daily. No product has been proven to be superior. I believe it reduces discomfort, swelling and the time it takes for the scar to settle. This should continue until the scar has matured, when it is flat and pale, and can take up to 12 months.

Problem Scars

If your scar becomes problematic I will suggest the use of silicon sheets. If used they need to be worn for at least 12 hours a day and are expensive. Corticosteroid injection, further surgery and radiotherapy are also common and effective methods of treatment in severe cases.

Written with the help of:

Monstrey S et al. Journal of Plastic, Reconstructive & Aesthetic Surgery 2014;67:1017-1025