Any suggestions on ways to treat the scar of a tummy tuck and breast lift? Mederma? ScarAway?

Question

Recently had a tummy tuck and breast lift....starting to look up ways to help with scarring....looking for suggestions. Thanks

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

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.

Eugene Kim, MD · Answer

Thanks for your
question.  I like to start scar treatment
within the first couple of weeks following surgery and there are a lot of
products out there that really help like BioCorneum, Embrace pads (which I like
to use for tummy tucks), etc.  I will
tell you that oftentimes the key ingredient in making good scars is
silicone.  I would suggest seeking the
advice of your plastic surgeon with regard to this.  I hope this helps.

Tom S. Liu, MD, MBA · Answer

After a cosmetic procedure, such as a tummy tuck or breast lift, it is necessary to begin a scar treatment early on in the healing process. You might want to try Embrace Active Scar Defense, which is a scar treatment that addresses tension, an important factor in scar development. Embrace comes in a variety of sizes, so it can be used to treat many types of scars. Consult your board-certified plastic surgeon regarding his or her recommendations for you. Congratulations on your recent procedures, and good luck in your recovery!

Ellen A. Janetzke, MD · Answer

For optimal scarring, there are three things we know to help aid in minimizing scars. 1) using an occlusive bandage, using a silicone, and releasing tension from the scar itself. In my practice we use the Embrace scar therapy system. By using this system my patients are achieving amazing results due to Embrace using all three requirements. I encourage you to research before an after photos so you can see the amazing results! Congratulations on your procedures and good luck!

Christian Subbio, MD · Answer

The best scientific evidence out there suggests that silicone scar stickers do the best job. As well, they don't leave any filmy or sticky residue that can get on your clothing like some silicone ointments or creams do. You can either order some online or look at any local pharmacy. This should have a scar fade section. Some companies make specific designs and patterns to match surgical patterns. And, keep the incisions out of the sun!Best of luck!

Dr. SubbioBoard-Certified Plastic SurgeonNewtown Square/Philadelphia, PA

Dr. SubbioBoard-Certified Plastic SurgeonNewtown Square/Philadelphia, PA

Steven J. Rottman, MD, FACS · Answer

Thank you for your question and congratulations on your recent surgery. I instruct all of my patients to perform daily scar massage and apply a silicone based scar ointment or tape to their incisions. Biocorneum makes an excellent product. Please ask your board certified plastic surgeon for specific instructions regarding his or her scar management protocol. Hope this helps!

Robert S. Houser, DO · Answer

The simplest thing is massage.  It doesn't matter what you lubricate your finger with so don't waste money on Mederma!  Silicone sheeting also has a lot of science behind it and certainly works.  The sheeting can be cumbersome for a tummy scar so I use Biocorneum.  It's a cream you apply 2x a day and it even have a sunblock in it.  Good luck!

John Zavell, MD, FACS · Answer

Provided that the scars are not wide, then a topical scar treatment, like Silagen, that contains silicone is a great option.  Silicone has been researched for years and proven to work on scars.  If the scars are wide, then a scar revision may be your only option.  Discuss this with your plastic surgeon, but remember that scars usually improve with time, so give the areas several months before passing judgment on how the scars look.  Good luck

Erica Anderson, MD · Answer

Your surgeon will likely have a regimen that he/she likes, but taping or silicone gel based products can be highly successful.

Tom J. Pousti, MD · Answer

Your plastic surgeon will have his/her preference when it comes to incision line “care”.  For example, some plastic surgeons prefer the use of tape ( applying pressure) along the incision line. The use of silicone-based products (creams or sheeting) may also be helpful in achieving the best scars possible.I hope this helps.

Any suggestions on ways to treat the scar of a tummy tuck and breast lift? Mederma? ScarAway?

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