Any surgery that requires incision or injury involving the deep layers of the skin, heal by forming a scar, which is permanent. A scar is a natural part of the healing process. Initially they can be red and raised, however, usually within 12 months most scars become flat, pale and leave a slight trace of the original injury which caused them. Scars form differently based on the location of the injury on the body and the age of the person. Scar tissue forms because the body is unable to re-build the damaged tissue exactly. It has a different texture and is usually of inferior functional quality.
In some cases, the body can overproduce the collagen used to form the scar which causes it to grow above the level of the surrounding skin.
- Hypertrophic scars: Appear as raised red lumps but do not extend outside of the original margins of the injury and the appearance will often improve after a few years.
- Keloid Scars: Are more serious because they can carry on growing outside the original margins of the injury and may often require further treatment. Keloid scars can be more common in children, females, certain ethnic groups and some sites on the body – most commonly flexor surfaces and particularly the chest.
- Pitted Scars: Appear as a sunken recess where muscle tissue or fat is lost from under the scar, the appearance of these types of scars can also improve over several years.
- Stretched Scars: Most commonly seen as stretch marks during pregnancy, where the skin is stretched rapidly but can also form due to surgery or injury. These will also improve over time.
Scars are noticeable for a number of reasons:
- The position of the scar on the body.
- The colour.
- The size.
- The contour.
- Whether it is distorting any surrounding structures.
No scar can ever be completely removed. You will always be able to see where the injury occurred; however, their appearance can be improved by a number of means.
Providing pressure to a healing wound with tape or compression garments can assist with significant flattening of raised scars. Micropore tape, easily purchased from most chemists, is flesh coloured and can be worn unobtrusively on the face to provide pressure to healing wounds. We recommend removing the tape prior to showering and replacing it after the wound has been dried thoroughly. For maximum benefit, micropore tape should ideally be worn 24 hours a day for several weeks. Tape can be used immediately after sutures are removed at about 2 weeks after surgery.
Once your injury has completely healed and the sutures have been removed, usually about 3-4 weeks after surgery you can begin massaging the scar. Using firm pressure that should be uncomfortable but not painful, move your finger in a circular motion over the entire length of the scar for approximately 20 seconds, paying particular attention to any raised areas within the scar. This process should ideally be repeated 5 times daily for up to 4 weeks. A moisturiser can be used whilst massaging, however, it is not essential.
Our clinic can provide patients with special silicon based scar dressings. Silicon dressings should ideally be worn over the scar for a minimum of 12 hours a day, the most convenient time is generally overnight. Dressings can, under normal conditions, be used for up to two weeks. The dressings are waterproof, however, we recommend removing the dressing before showering to prolong its use. Flesh coloured Micropore tape over the silicon dressing will help to adhere it to the skin if extra fixation is required. The Micropore tape can be replaced over the dressing whenever necessary. These dressings may not be required in all situations, so please speak with our practice nurse.
Scars do not contain the normal pigments that protect skin from UV rays and therefore, burn more easily – particularly in young children. For the first three months, a suitable high UV protection sunscreen such as clear zinc should be applied over the scar.
There are many factors that influence the development of a scar but most will heal very well in the first three months and will need no treatment. It can, however, take up to a year or more to improve a scar, so please be patient.
If you require any further information from Waverley Plastic Surgery about post-operative scarring, please contact us online or call (03) 9807-8300.
Click Here to download our Scar Management information sheet.