Any good plastic surgeon knows that "incisions" and the resulting "scars" are extremely important to patients. No matter how the size or scope of surgery, people care what their incisions look like and the scars that result, it is safe to say that nobody wants their incisions to be deforming, even more so as it relates to the face. This article covers some common sense rules for minimizing scarring associated with a surgical incision.
Before we get into that topic however, it is important to note that anytime an incision is made, there will be some sort of mark on the skin in that location. By the very definition, plastic surgery inherently implies the creation of a wound and, consequently, all wounds create scar. The key to minimizing a scar is to make well planned-out, minimally-traumatic incisions that heal well and are minimally noticeable.
A scar is actually nothing more than in incision that might not have healed optimally or has become noticeable. It is also important to note that "scars" are inherently subjective. What one person may regard as a "scar," someone else might regard as a non-issue.
1. Proper Wound Care Post Surgery
The first principle, and probably the most important, is to simply decrease the chance of scarring and optimize incision healing with proper initial wound care. This starts the moment the operation is over and is really not complicated; in fact, it is essentially in line with what your mom probably taught you about getting that skinned knee to heal when you were 10 years old. Limited motion is helpful in the initial stages of healing. One wants to not re-traumatize an incision/wound that is healing - so no picking or scratching or rubbing.
Also, preventing infection is a key concept. If a wound gets infected, it gets re-traumatized and the whole healing process will be set back. This is why most doctors will place their patients on antibiotics prior and/or after a surgical procedure. This is also why your doctor will tell you to clean your incision with antiseptics and apply antibiotic ointment. A further benefit of using an emollient (moisturizer) like antibiotic ointment is that wounds heal more quickly in moist environments. Emollients also improve the overall health of the skin surrounding the wound. Lastly, most of us have realized at this point that the sun and its UV radiation can be damaging to the skin - this is especially true for healing incisions. One must not sunburn or tan his/her incisions. This not only slows the healing process but may permanently darken the incision and thus make it more noticeable.
2. After the Incision Has Healed
The next concept is also simple. Once the wound has healed and the sutures are out (7-10 days later), one wants to optimize the collagen deposition so that the most favorable result occurs. Collagen is the most abundant ingredient in normal, healthy human skin. There are several products that are useful for optimizing the deposition of collagen if they are used 8-10 weeks after surgery, but not much benefit is seen thereafter. Again, please staying out of the sun as much as possible, and if you do go in the sun, use >30 SPF sunscreen during healing and for at least the first 6 months after surgery.
3. Once a Scar is Evident
This is really a topic for a different article, but the reader should find solace in knowing there are good options - options that range from steroid injections to dermabrasion to laser resurfacing to scar revision surgery. One specific recommendation that I have seen some success with is the application of silicone impregnated bandages or gels (i.e. invincible穢, etc.). Despite much research on this topic, the medical community hasn't figured out how exactly this works at the molecular level, but it does provide benefit in most patients.
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