Wound Care After Surgery: How To Minimise Scarring
Choosing to undergo cosmetic plastic surgery is a personal choice, and one that is often private. Maybe you told your mum. Maybe you told your closest friends. Maybe just your partner. Perhaps you told your work colleagues (after all, they’re going to notice that your face is different anyway). Maybe you told everyone. Or no one. And hope that nobody notices.
There are many reasons why people have cosmetic surgery. Maybe you lost a massive amount of weight and having that loose skin cut off your abdomen was the final step in your hard-earned transformation. Maybe you’ve always been self conscious about your nose and getting rid of that dorsal hump has liberated you and given you more social confidence. Maybe the mummy-makeover was a gift to yourself after years of raising kids and always putting everybody else first.
Whatever the reason, most people wish to have a natural and subtle enhancement to their looks, and how the wounds heal is a significant part of that. By choosing a plastic surgeon, you have already made that first step. Plastic surgeons are skilled at wound closure to ensure the best possible aesthetic result. However, what happens after surgery is also important, and everybody has their two cents about wound healing. Some people swear by vitamin E cream. Others stock up on Bio Oil. Your neighbour’s aunty’s cousin Bertha has a secret ointment made from her garden. It’s hard to know who to listen to sometimes.
Currently, there is scientific evidence for scar massage and silicone. When do you start? When do you stop? Why does my scar look different to someone else who had exactly the same surgery?
Scar therapy can start about two weeks after your surgery; once you have had all your stitches or staples removed. All wounds undergo a process called “remodelling” which means that over the next few weeks and months after surgery the wounds have the potential to change. Any lumps and bumps tend to smooth out over this period, and you can help improve the process by two methods: massaging the scar with firm but gentle pressure, and the use of silicone. Silicone comes in different forms – as a sheet that you can place on the wound, and held in place by a compression garment, or as a gel that you can rub onto the wound. The type of silicone you choose depends on what surgery you had, and what is practical. Your surgeon will help you choose the right one.
Scar therapy should continue for at least three months. Most people find it difficult to keep going after this time, but if you can, there is benefit in continuing scar therapy for a year. This depends on the state of your wound, too. If you have healed beautifully and don’t feel the need to continue, you may stop after three months. If you have a pink, thick wound you might continue to see improvements by keeping up the therapy.
The appearance of a scar depends on many factors. Some factors are genetic, and therefore out of our control. Certain skin types (usually darker skin) are more prone to developing thicker, or “hypertrophic” scars, or lumpy “keloid” scars that extend outside of the incision. Another factor is where the operation was on your body. Scars on the shoulder or chest region tend not to heal as well as scars on the face or hands, for example. If your surgical scar is over an area of mobile skin, your surgeon may put some tape over it to keep the scar still. This is very important to keep on. Any pulling forces on the scar will cause it to stretch and widen.
What can be done about wounds that aren’t healing well despite our best efforts? If you’ve used silicone and massaged your scars and still feel as though your scar is thickened and pink, do go back to see your plastic surgeon. There are further options for people who develop hypertrophic or keloid scars. These include steroid injections and further surgery to remove the scarring. Your plastic surgeon will carefully assess your scars and talk you through the different options.