Reducing scars after plastic surgery is a goal of just about every one of our patients at Desert Hills Plastic Surgery Center. Board-certified plastic surgeon Dr. Hayley Brown can help you promote proper wound healing, ultimately resulting in the lightest and flattest scar possible. Unfortunately, there are a lot of misconceptions and misleading marketing out there regarding scar treatment. Please read below to see what those misconceptions are.
Does Vitamin E Work?
Don't fall for the vitamin E myth! Your mom may have told you that vitamin E is the best thing for treating scars, but it can actually worsen their appearance. Vitamin E sometimes causes an allergic reaction called contact dermatitis. This allergic reaction usually causes inflammation and a rash, which will impede healing along the incision. And there's really no reason to try it: Scientific studies didn't find a difference in scar quality from twice-daily application of vitamin E, Vaseline or Aquaphor.
What About Mederma or Neosporin?
Mederma: Dr. Brown has reviewed at least three controlled studies showing no proven benefit when Mederma is used for scar treatment. You would see more benefit from applying lotion or Vaseline to a scar – three times per day for 8 weeks – than you would following the same regimen with Mederma. Dr. Brown's advice is to skip this product and others like it completely.
Neosporin: This popular antibiotic ointment will help the incisions heal in the first two weeks after surgery only. You must stop using it once the wound is closed and healing. After that, Neosporin may cause contact dermatitis, creating the same rash and inflammation possible with vitamin E application.
Dr. Brown instructs her patients not to use vitamin E or Mederma on their incisions and scars. Instead, she asks them to keep in touch with her as their incisions heal – attempting to care for your scars on your own with information from the internet or television, or word of mouth, can result in an unnecessarily unsightly scar.
How To Reduce the Appearance of Scars
Over years in practice, Dr. Brown has determined what works for scar reduction:
1. It starts with the plastic surgeon you choose. You want a plastic surgeon like Dr. Brown who meticulously and precisely closes the incision. Proper incision closure sets the stage for good wound healing.
2. Hydrate the healing scar to keep it moist. Wounds heal most effectively when the area is moist, not dry. The skin will fill in faster and the scars will be less visible – but the area should be dry at first. After complete incision healing, about 1-2 weeks after surgery, Dr. Brown recommends Cetaphil lotion to keep the scar soft and supple. Other options are Aquaphor or petroleum jelly. Having said all that, there should be a delicate balance. If the area gets too moist, then an infection may take hold or the tissue may not heal properly.
3. Massage the scar regularly. It helps soften and smooth scar tissue.
4. Silicone sheeting may be a good option, depending. Consistent use of silicone sheeting has been shown to reduce the visibility of scars. They can be purchased at our office or over-the-counter at your local grocery store or drugstore. Most likely these strips are effective because they apply pressure and hydration. The patient must wear them often enough for them to work, however, which can be difficult for some people to stick to. Sheets will need to be worn over the scars for most of the day and night, for a number of months.
5. Bleaching creams may work, depending. Dr. Brown sometimes prescribes hydroquinone for patients with a history of scar pigmentation. It's a topical cream that will need to be applied twice a day. It can take 4-6 months for this method to work, and strict compliance with applying the cream is required.
6. Steroid injections may be recommended, depending. These injections may be recommended for hypertrophic and keloid scars. Dr. Brown must examine the scars first. About 6 weeks after surgery, Dr. Brown will be able to determine if the scar should be treated with a series of injections once every six weeks.
7. Protect the scar from sun exposure. Sun exposure worsens the appearance of scars. Sunscreen is required to prevent darkening and persistent redness. After surgery, the skin on the treatment area will be very sensitive to the sun. Sunscreen must be worn on that area for at least a year after surgery (when the area is exposed to the sun).
8. Take care of yourself and be well. A nutritious diet will support wound healing. It's also important not to smoke! Smoking is of course bad for you anyway, but it also impedes healing.
What about old or mature scars?
The treatments mentioned above are for immature scars, scars that are in the process of healing and remodeling. Usually after 1 year or longer, when the pinkness of the scar is resolved, the scar’s appearance is permanent. Here are options for improving scar quality in mature scars:
1. Surgery. Surgical scar revisions DO NOT remove scars. Plastic surgeons perform surgical scar revision to alter its size, make it narrower, re-orient it so that it lies along natural skin folds and tension lines, and to improve upon depth and irregular texture. Surgery for hypertrophic or keloid scars has a very high risk for recurrence. Since the recurrence rate with surgical excision alone in keloid scars is about 50 percent, surgical excision is usually combined with one or more of the other listed techniques.
2. Injectible fillers. Injecting substances such as Juvederm or fat can immediately raise sunken scars. However, this treatment doesn’t last permanently and may need to be repeated.
3. Dermabrasion. This procedure uses special equipment to remove the surface of the skin, helping to reduce the look of raised scars. Basically you sand down the skin so it is more level. It works best on the face, but results can be subtle.
4. Laser resurfacing. This is done two ways: The skin surface is removed with lasers, or lasers are used to work on the collagen in the dermis without removing the upper layer of skin.
Trust Your Care to Experienced Hands
Dr. Brown wants each of her patients to get results they love. She'll make sure you know how to help your scars heal so that they are as light and flat as possible. Dr. Brown will monitor how your scar is maturing and provide custom recommendations as time passes. To learn more about us or to arrange a consultation, please call Desert Hills Plastic Surgery Center in Las Vegas at 702-260-7707.