Minimizing scars has many factors to consider. How to heal and help minimize your surgery scar after your cosmetic surgical procedure with Dr. Lundeby. Scar tissue forms as the skin’s natural healing response to trauma, whether from a cut, puncture, burn or controlled injury to the skin as the result of surgical incision. The skin reacts by contracting and closing over the open wound (or sutures) and rushing collagen-producing fibroblasts to the site of the injury to produce the new skin cells that form a scar.
The skin can reveal the whole general condition of the patient—and in the case of scarring, it also allows me to ascertain how well a patient will heal. A host of variables affect the severity of scarring, including the area of the body, skin laxity, age, ethnicity and skin tone. For example, darker skin tones and redheads are both more susceptible to problematic scarring, while most fair skins tend to scar very well.
Your Age: As we age, our skin becomes less elastic and becomes thinner. This is because collagen (which makes the skin elastic) changes as we age, and the fat layer under our skin becomes thinner. The result of these changes, along with sun exposure, smoking, exposure to the environment and other lifestyle issues, means that skin does not heal as well or as quickly as we age. The benefit to age is that the imperfections that occur over time, like sun damage, work to help conceal scars that might be more obvious on younger skin.
Genetic (Inherited) Tendency To Scar: If your parents or siblings tend to scar heavily, you are likely to do the same. If you have a family tendency to scar badly, you may want to discuss this with your surgeon.
Size and Depth of Your Incision: A large incision is much more likely to leave a scar than a small incision. The deeper and longer the incision, the longer the healing process will take and the greater the opportunity for scarring. A larger incision may be exposed to more stress as you move, which can cause slower healing.
How Quickly Your Skin Heals: You may be one of the genetically blessed people who seem to heal magically, quickly and easily with minimal scarring, or you may be diabetic and your skin tends to heal slowly. How quickly you heal is a personal thing and can change with illness or injury.
Smoking: Not only does smoking increase your risk for scars, it can also slow your healing. Smoking is such a significant risk factor that many plastic surgeons will not operate on a patient if he does not quit smoking COMPLETELY for at least 2 weeks prior to surgery.
Drinking: Alcohol dehydrates both the body and skin, which decreases your overall state of health. While your wound is healing, avoid alcohol and focus on non-caffeinated beverages.
Nutrition: Eat a balanced diet with an emphasis on protein intake. Protein makes up the building blocks of healing skin, so it is essential to provide your body with adequate protein (chicken, pork, fish, seafood, beef, dairy products) to allow your skin to heal. If you do not like eating meat, soy products provide an excellent alternative as a lean protein source.
Hydration: Dehydration happens when you are not taking in enough fluids. In severe cases, this can cause electrolyte imbalances and heart issues. In less severe cases, you will feel thirsty and your overall health will be diminished. Staying well hydrated (Tip: If you are well-hydrated, your urine will be almost colorless or light in color) will help keep your healing headed in the right direction.
Your Weight: If you are overweight, you may be at greater risk for scarring. Why? The fat under your skin can work against your surgeons best efforts to close your incision seamlessly.
Rest: If your doctor suggests that you rest for two weeks, don’t go back to work after one week of healing. Exhausting yourself will not help your wound heal and can actually slow healing.
Proper Wound Care: Taking the steps recommended by your surgeon may be the single most important thing you can do to prevent scars. Taking measures to prevent infection, refraining from using ointments and remedies that are not prescribed, and other general incision care techniques are essential to healing without scars.
Identify Infection Quickly: If your incision becomes infected, it is important that you can identify the signs of infection and seek help from your physician immediately. An infection can seriously impair healing and can contribute to scarring.
Chronic Illness: Diabetes and many other illnesses can slow healing. For the best possible outcome, your illness should be as well-controlled as possible before surgery and during your recovery. For example, for a diabetic it is essential for blood glucose levels to be within normal limits as much as possible as high levels slow healing.
Stress on Your Incision: Putting stress on your incision by lifting, bending or doing anything that stretches or puts tension on the incision should be avoided. This stress can pull the incision apart, delaying healing and often making the wound larger than it needs to be, which increases the size of your scar.
Exposure to Sunlight: Avoid having the sun on your incision whenever possible. If your scar is in place that is difficult to cover, such as your face, invest in a good sunscreen. Your surgeon can tell you when it is safe to apply ointments, but it is usually safe to do so when the sutures are removed or the incision has closed completely.
Fever: A fever is often accompanied by feeling chilled. A fever can also decrease your appetite, lead to dehydration and a headache. A low-grade fever (100 F or less) is common in the days following surgery, a fever of 101 or more should be reported to the surgeon.
Hot Incision: An infected incision may feel hot to the touch. This happens as the body sends infection fighting blood cells to the site of infection.
Swelling/Hardening of the Incision: An infected incision may begin to harden as the tissue underneath are inflamed. The incision itself may begin to appear swollen or puffy as well.
Redness: An incision that gets red, or has red streaks radiating from it to the surrounding skin may be infected. Some redness is normal at the incision site, but it should decrease over time, rather than becoming more red as the incision heals.
Drainage From the Incision: Foul-smelling drainage or pus may begin to appear on an infected incision. It can range in color from blood-tinged to green, white or yellow. The drainage from an infected wound may also be thick, and in rare cases, chunky.
Pain: Your pain should slowly and steadily diminish as you heal. If your pain level at the surgery site increases for no apparent reason, you may be developing an infection in the wound. It is normal for increased pain if you “overdo it” with activity or you decrease your pain medication, but a significant and unexplained increase in pain should be discussed with your surgeon.