After breast lift surgery, can I use Scarguard with silicone sheets?

Question

I don't know which one to use so I figured I use both and get quicker results. I heard Scarguard is good because it's 12% silicone and hydrocortisone. I also heard it's also important to keep the scar pressed down with some material and my PS recommends silicone sheets which only have 4% silicone. I've decided to use both...will that be fine, if not then which is better? Thanks.

Larry S. Nichter, MD, MS, FACS · Answer

Both #ScarGuard and #SiliconeSheeting are good options. Here is some additional important information on how to #AcheiveTheBestScar.Best Scar Management is important to minimize or completely hide from view, the telltale signs of your surgery—namely, scars. Both you and your surgeon want you to have the most minimal scarring possible. There are many possible causes for scars that are enlarged or not healing well. Unsightly scars are most commonly due to genetics, underlying medical conditions, or improper scar/wound care. The last part is very important and patients can make a noticeable difference in their scars’ appearance by following best scar management practices. Here are some simple tips.Scar Management tips:Minimize tension on the scar. Steri-Strips and/or surgical tape are often placed in non-hair bearing areas at the time of surgery to minimize tension and keep pressure over the scar.  This minimizes the  stress that  can pull the scar apart (dehiscence) creating a wound and  delaying healing time, and can make the scar wider, or more “ropy”. In the first few weeks after surgery, I recommend the use of Embrace Scar Therapy which is an adherent silicone sheeting pre-stretched when applied so as to offload tension on the scar.Keep your incision site/scar clean to prevent infection. Follow your surgeon’s wound care instructions to the letter with out modification. Never apply different products then recommended without first discussing them with your surgeon. This is especially important during the first few weeks. If there are any signs of infection, contact your surgeon’s office right away and/or see your doctor or his nurse immediately. Typical signs of infection may include redness outside the immediate incision site, asymmetric swelling, and drainage, of pus, fever, chills, and “feeling sick”.Protect your scars from the sun. Staying out of the sun is the best advice. Minimal exposure to sunlight is prevents hyperpigmentation (permanently turning brown) and other problems that can make the scar more noticeable. Sunscreen, at least 30 SPF and an overlying make camouflage make up additionally protects the scar from the suns harmful rays. This advice is especially important the first year following your surgery.Use specific scar maturation products recommended by your surgeon. Patients seem to have their own opinions on this touting everything from Pure Vit E, Coco butter, to Aloe Vera, etc but most have minimal benefit other than keeping the scar hydrated. Although hydration is important there are better, scientifically studied products with greater efficacy. Most of the scientific articles written about this subject indicate that topical silicone gel or silicone sheets work the best. The best product available in my opinion is the Embrace Scar Therapy System by Neodyne BioSciences, Inc. available in many surgeons’ offices. Essentially this is an adherent silicone sheeting pre-stretched when applied so as to offload tension on the scar. For areas that are not applicable for this product (e.g. smaller areas or on the face), I prefer BioCorneum or Kelo-Cote products There are a lot of products to choose from, but silicone should be one of the key ingredients. Although Mederma, an onion extract derivative active ingredient rather than mainly silicone based may help, primarily silicone based products are better and many also contain other ingredients that may be synergistic (hydrocortisone or other steroid, Vitamin E, Sunscreen, etc).. If the reader has problems obtaining these they can call my office. Patient compliance is also critical – use often and according to directions or it will not work optimally. NEVER apply products without first discussing them with your surgeon.Monitor to make sure your scar is progressing optimally. Keep your scheduled follow-up appointments with your surgeon to verify that your scars are maturing as expected.  Occasionally if indicated you may need a topical steroid preparation or even a series of  injections (5-FU and/or Steroids) or laser treatments  to treat or  prevent scar hypertrophy or keloid formation (red raised scars), or other topical medicines to treat post inflammatory hyperpigmentation (brown scars) with prescription creams and possible laser treatments.

Young R. Cho, MD, PhD · Answer

Thank you for your question.  Breast incisions can be managed using a multimodal approach:1)  Scar massage - starting as soon as the surgical dressings come off and the incisions are sealed2)  Silicone sheets or scar gels for about six months to year.  The actual percent of silicone is less important than keeping the incision gently compressed and hydrated3)  Embrace - a tension reducing dressing for the first 2 months4)  Fractionated lasers to help blend the scar into the background - done as a series, starting about 4 weeks after surgery and repeated every four weeks for six months.5)  Sunscreen to prevent the scars from darkening

Lewis Albert Andres, MD · Answer

Hello!  Thank you for your question. It is common for scars to fully mature for up to a year. In the meantime, there are a few things that may help to ameliorate your incision/scar. The most proven (as well as cheapest) modality is simple scar massage. Applying pressure and massaging the well-healed scar has been shown to improve the appearance as it breaks up the scar tissue, hopefully producing the finest scar as possible. Other things that have been shown to add some benefit are silicone sheets, hydration, and topical steroids.  Both choices should be adequate.  In addition, avoidance of direct sunlight to the incision will significantly help the appearance as they tend to discolor with UV light during the healing process. If unsightly scars are still present after approximately a year's time, other things that your surgeon may consider are intralesional steroid injections, laser, or just surgical revision of the scar itself. Hope that this helps! Best wishes for a wonderful result!

Matthew H. Steele, MD · Answer

Thank you for your question.  I have recommended both products to my patients.  The downside with ScarGuard is the long length of scar and potential quick use of the product.  The silicone sheets are reusable and may be cheaper in the long run.  A new product, Embrace is now available, and has shown some very nice results on tummy tuck scars.  There is work in progress to tailor this new scar therapy toward breast incisions around the nipple/areola.  Preliminary evidence has shown improvement on the horizontal and vertical breast scars with this new product.  Good luck!

Lee E. Corbett, MD · Answer

I have used both products and both help scar maturation. However, I have not used both in conjunction but I cannot see why this would be a bad thing. But don't know that it will help you get "quicker results" either.

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After breast lift surgery, can I use Scarguard with silicone sheets?

Answers (7)

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