Before & After Gallery

Scar Compression-Massage and Advanced Scar Care

Basic scar treatment begins around 3 weeks after surgery.  Silicone sheeting and scar massage improve the appearance of the scars.  The increase moisture and warmth provided by the silicone sheeting may lead to an increased rate of collageneolysis during the remodeling phase of wound healing leading to falter scars with improved color.  We have learned by observation that the application of pressure to a scar can also improve the scars appearance as demonstrated in the photos below.  Notice the improved appearance of this patients mid-line sternal scar in the region of her bra strap.  This improved scar outcome is the direct result of continuous pressure applied to the scar from the bra strap.  Both silicone sheeting and scar massage may help improve existing scar appearances for up to two years from the initial scar tissue formation.  Newer silicone gel products offer more convenience for patients as they do not require re-use and can be simply washed off before applying new product.  More advanced early scar care is also available such as Embrace.  Embrace scar treatment is designed to prevent widening of the scar by helping to pull it together during the early stages of scar maturation.  This reduces tension on the scar line which leads to a more favorable scar appearance.

 

Favorable scars have four features which help them to be optimally concealed and less noticeable

Favorable Scar Traits

  1. Thin and not wide
  2. Flat and not raised or depressed
  3. Similar color to surrounding skin
  4. Similar texture to surrounding skin

 

Wide scars do not improve dramatically with scar treatments.  Scar revision is usually necessary for an improved outcome with the goal of removing the wide scar and replacing it with a thinner one.  Raised scars are ideal for traditional scar treatments including silicone sheeting and scar massage.  If the scars become hypertrophic or develop keloid characteristics, steroid injections may be useful to help flatten a scar.  Depressed scars can be improved by filling in the depression with tissue such as fat or dermal grafts.  Tissue fillers can also provide a temporary improvement by filling in the hollow.  Scar revision with excision of the depressed scar and replacing it with a flat scar is also an option.  The color of a scar naturally improves over time (sometimes taking 1-2 years).  The color of the scar can also be improved with laser or photo-facial treatments designed to decrease the red color in the scar.  Dark or hyper-pigmented scars may benefit from a skin bleaching product containing hydroquinones.  Protecting the scar from sun exposure with sun blocks and clothing is essential during healing and scar maturation, as sun exposure can permanently change the pigment in a scar.  The texture of the scar may improve with alternative skin therapies including laser procedures and micro-needling procedures including the application of platelet rich plasma or growth factors to help promote new healthier collogen formation.  Scar revision may be the best option for scars with significant change in texture with the goal to excise the irregularly textured scar and  replacing  it with scar with similar texture to the surrounding skin.

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