One of the many factors patients encounter when deciding to have facial surgery is the potential for scarring. Any time the skin is cut, a scar will result as a healing response. However, there are many innovative solutions to minimize scars during surgery and ways to deal with them if they happen to occur.
Proper surgical technique is imperative to preventing scars in the first place. Accurate placement of the incision and precise tissue handling will ensure the best scar result. Closure of a wound is important as well. Using subcuticular stitches under the skin and puckering the skin edges outward that will dissolve and an outer layer of stitches that will be removed after 4 to 5 days avoids more noticeable scars, such as wide and depressed scars and railroad tracking.
Scar placement is also a big factor in avoiding visible scars. I hide scars as best I can no matter what surgery is being performed, but cosmetic surgery scars are much easier to hide because we choose to place the incisions in less noticeable areas. For example, during a facelift, the smallest s-lift (short scar) or mini facelift incisions are used and hidden around the ears and should settle into the natural creases of the face. Blepharoplasty scars are also barely visible as they are concealed in the natural creases around the eye.
Steroid injections can help flatten raised scars (hypertrophic scars) and also help with any pain or itching the scar may have caused. Skin cancer reconstructions, facial trauma, or other surgeries might make hiding scars difficult. Sometimes a scar revision is necessary to correct old scars, or scars from incisions that were not stitched properly.
Topical scar creams are suggested for complete healing of a scar. We suggest BioCorneum + Advanced Scar Supervision Plus SPF. This silicone treatment is used for the prevention and management of hypertrophic (raised, red) scars and keloids. The SPF 30 UV protection ingredients also protect the scar from darkening in the sun.
Laser Therapy can help to minimize old and new scars by stimulating collagen reproduction, smooth skin, and reduce redness. Each scar is different, but our Cutera laser system has Laser Genesis for scar remodeling with no downtime or laser skin resurfacing options to diminish the appearance of a scar after procedures and help blend them away.
Surgical Revision might be necessary for old scars that were not closed or taken care of properly. Accident victims are often candidates for surgical scar revision because of improper stitching in the ER. During surgical scar revision, old scar tissue is removed and the area is restitched in order to create a less noticeable scar.
Talk to a dual board certified facial plastic surgeon to decide which method is best for your scar.
Post provided by Benjamin Stong, MD