Weight Loss & Fitness

Minimizing the appearance of surgical scars after plastic surgery : ObesityHelp


August 17, 2022

You expect to have scars after reconstructive surgery due to weight loss. However, there are ways to minimize the appearance of surgical scars after plastic surgery.

Plastic surgeons offer scar treatment that can help. You may find it reassuring to learn more about your scar revision options and what you can expect after your surgery.

Maturation of scars

After surgery, the appearance of the resulting scars can be unsettling at first. Please understand that each scar goes through a maturing process that can take up to two years.

In short, what you see at the start of the healing process is not what the scar will look like forever. It will change as the collagen changes from type three to type one. During normal healing, collagen fibers are rebuilt and scars fade and flatten.

However, not everyone’s scars heal in the same way and sometimes there are variations from normal healing.

Hypertrophic scars

Sometimes the scars become thick and raised as they heal. This is called hypertrophic scarring, which basically means too much scarring. Hypertrophic scarring is an abnormal response to scarring.

Hypertrophic scarring occurs when extra connective tissue forms in the wound area. This type of scar is common when people undergo surgery.

Keloids

Keloids are similar to hypertrophic scars, except with this type of scar, the connective tissue extends beyond the original wound area. These scars can become quite large.

Keloids are more difficult to treat and may pose an increased risk of cancer. Without treatment, keloids will never fade or disappear.

Options for treating scars

Fortunately, there are options for treating scars. Scar treatment falls into two different categories: passive treatment and active treatment.

Which one is right for you will depend on your type of scar: normal, hypertrophic or keloid scar. It can be helpful to understand what to expect when speaking with your plastic surgeon.

Passive processing

Passive scar treatments are non-invasive and can work very well for patients with scars after reconstructive surgery. However, optimal results from scar treatment depend on adherence and dedication on the part of the patient.

Silicone Cream

Silicone cream can help in several ways, such as:

  • Reduce the size, hardness and redness of the scar.
  • Improve swelling and itching.
  • Prevention of a raised scar after surgery.

Silicone creams and gels have proven extremely effective. Since silicone creams can easily be wiped off, it is important to reapply them if necessary.

silicone bands

Silicone strips are another type of topical scar treatment. The strips are thin sheets of silicone that patients wear around the clock. They are placed over the scar.

The silicone in the bands is able to reach the deeper layers of the skin. Over time, silicone strips can reduce the appearance of visible scars. Patients using silicone bands may experience:

  • Smoother scars
  • Less colored scars
  • Scars with less elevation

Compression

Compression is another passive form of scar treatment that can reduce scarring and improve the cosmetic appearance of scars. Scar compression is used as a preventive and corrective method of scar treatment.

Compression garments are used to prevent the formation of hypertrophic and keloid scars. Compression garments can help improve the rate of scar maturation.

Studies have shown that scars treated with compression have less collagen production, making it a good option for some patients after reconstructive surgery.

Active processing

For many patients, even after all of the passive treatments mentioned above, the scars may not look optimal. You may need one of the following active treatment options instead.

Laser treatment

There are two different types of laser scar treatment. VBeam is for fresh, new, and pink scars, and Fraxel is for more mature, non-pink scars.

VBeam works by improving the look and feel of your scars. It targets the deeper layers of your skin to stimulate collagen production. Depending on the severity of your scars, several treatments may be required to achieve the desired appearance.

Fraxel laser treatment works by gently damaging the skin to stimulate collagen production. When the skin is slightly damaged, it stimulates the body’s healing process to create new cells and collagen.

Injection of steroids and 5-FU

5-Fluorouracil has been shown to successfully treat hypertrophic scars and keloids; especially when combined with steroid injections.

When injected with 5-FU alone, many patients experienced flattening of scars, resolution of scar pain, and no recurrence of their scars.

Other studies indicate that 5-FU is even more effective with the administration of corticosteroids. This combination can reduce the appearance of scars and reduce the risk of recurrence.

Microneedling

Microneedling involves using adjustable needles to penetrate the skin at different depths. The needles form micro-channels which stimulate the production of collagen.

The new collagen deposited at the site of the scar restructures the skin and thus improves the appearance of the scar. After microneedling, many patients find that their scars are softer and smoother with less defined edges.

Microneedling can give quick results in some patients. However, the results depend on the severity of the scars. Some patients will need microneedling treatment for several months before seeing any improvement.

Dermabrasion

Dermabrasion is a type of skin resurfacing that removes the outer layer of skin using a fast-spinning device (much like a sander, but medical grade, of course!). Patients’ skin is either anesthetized or given a sedative.

After dermabrasion, the regrown skin looks smooth and scars are effectively minimized. This procedure requires three to four weeks of healing. Dermabrasion works quite well to help with healing.

Surgical revision of scars

There are cases where other forms of scar treatment are not effective. Each patient is different and for some, surgical revision of the scar is a necessity.

A scar revision can change the appearance of a scar, improve the itching of the scar, and even restore body function that the scar was bothering. In some cases, patients with keloids may require scar revision if other forms of treatment do not work.

Your plastic surgeon provides treatment for surgical scars after plastic surgery

If you’re battling unsightly, itchy or painful scars, help is available.

Please call a board-certified plastic surgeon to schedule a consultation to determine which scar treatment method is right for you. They can provide you with several types of treatment, including the passive and active options listed above.

Dr. J. Timothy Katzen specializes in reconstructive plastic surgery

Timothy Katzen

ABOUT THE AUTHOR

Dr. J. Timothy Katzen is board certified by the American Board of Plastic Surgery and is president of the American Society of Bariatric Plastic Surgeons. Dr. Katzen specializes in reconstructive plastic surgery after massive weight loss. He has written numerous articles and lectured around the world on how to perform plastic surgery on patients who have experienced massive weight loss. Dr. Katzen has plastic surgery offices in two different states and two different countries. Specifically, it has offices in Beverly Hills (California), Las Vegas (Nevada) and Dubai (United Arab Emirates). Read more articles from Dr. Katzen!


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