Scars are a common concern in the world of facial plastic surgery and in life. Whether a scar arises from a fall-related injury, car accident, or elective surgery like a blepharoplasty, there are many effective ways to make scars heal in a really favorable and imperceptible way, says our facial plastic surgeon Dr. Inessa Fishman. There are also lots of ways to make scars look better even after they have done quite a bit of healing.
A really important part of how a scar looks is how it is repaired, says Dr. Fishman. It is essential to sew the wound closed in a way that minimizes tension or pulling on the skin edges. The stitches under the skin are important to create this tension-free closure, and redraping the skin, if possible, to decrease pulling or gaping of the wound, is important too. Beyond the repair, meticulous wound care can make for a prettier scar. Careful cleaning of your incision, prevention of crusting, and keeping the skin edges moisturized with a bland emollient like Vaseline or Aquaphor helps make your facelift or liplift scar heal in the most optimal, narrow, and imperceptible way.
Taking out the skin stitches at an appropriate time can also help the scar look better. “For most facial incisions or laceration repairs, I like to take out stitches at 4-7ish days,” says Dr. Fishman, noting that leaving stitches in too long can lead to undesirable dots of scar around an incision known as “train-tracking.” Leaving stitches in too long in hair-bearing skin like the scalp can make ingrown hairs more common.
A scar, no matter whether traumatically or surgically created, takes a a year to heal completely. During the healing process, especially during the initial red and pink phases of a scar, silicone scar gels or sheets are helpful to moisturize the scar tissue and keep it flat. “There are tons of great silicone brands available, including Silagen and ScarAway,” says Dr. Fishman, “and I normally recommend patients use them once-twice a day on clean dry skin, with 4-6 months’ use.” Laser therapy, IPL (photofacial) treatments, microneedling, and dermabrasion are common adjunct treatments to improve scar texture, and to decrease excessive redness or dilated capillaries around a scar. A lot of these treatments have significant benefit when started as early as 3-4 weeks after the creation of a scar. Their specific combination and timing are highly dependent on your individual anatomy, skin pigmentation and quality, and propensity for scarring, says Dr. Fishman.
Lots of scars go through a “bumpy” period during the initial few weeks of healing, and this bumpiness tends to peak at 6-8 weeks post injury, when collagen production is at its maximum within the scar. Conservative injections of anti-scar medications such as the anti-inflammatory steroid Kenalog and the anti-scar medication 5-fluorouracil, and scar massage, can help smooth this bumpiness and prevent scar tissue from growing excessive.
Surgical scar revision is a treatment option for scar that are depressed, overly raised, or wide. “In general, favorable scars are narrow–like a pencil mark,” says Dr. Fishman, “and I can improve the appearance of some scars by removing them and putting a new, narrow, and flat scar in their place.”
Micropigmentation or medical tattooing can be a wonderful treatment option for scars that are of a different color than the surrounding skin (and have lost their initial redness or pinkness). A light (or hypopigmented) scar across the red part of the lip or surrounded by a bit of hair loss within the scalp may benefit from tattooing pigment into the scar, or around it. It’s usually best for scars to be at least 10-12 months old before considering tattooing, to allow for as much healing as possible before altering scar pigment.
Are you worried about your scar? Want to learn more about scar treatments? Call or text us at 678-974-8435 to set up your personal consultation with our expert team to learn more about the scar treatment options we offer.