Are my scars healing properly? (Photos)

Question

I'm concerned about the raised appearance . It's very hot and humid where I live and I'm constantly sweating in the bra . I was told to put gauze and tape but the dressing is always spotted with red or yellow . Should I be concerned ? I'm 10 days post op .

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.

Gary Lawton, MD, FACS · Answer

Spotting with fluid of any kind is not normal.  You need to be seen by the plastic surgeon that operated on you.

Christopher J. Davidson, MD, FACS · Answer

Thank you for your question and photographs.  10 days post op is too soon to evaluate a scar.  That being said, it is very common for scars to be raised and red for some time during the healing process.  According to your photograph, all seems fine so far.  Best of luck.

David Tauber, MD · Answer

At 10 days, you are still within the early post-operative period. This stage lasts about 2-4 weeks as the deeper tissues heal. At this point the incision is forming scar tissue to hold the edges of the incision together and to help withstand the pressure of the implant. It is not unusual for an incision to be firm and raised to the touch due to this scar formation, edema of the tissues, and the tension of the sutures.Only your surgeon can offer a true evaluation of your healing. Continued close follow-up is essential.

Jerome Edelstein, MD · Answer

Hello,It would be best for you to have wound/incision issues assessed by your doctor in person.All the best

Joshua D. Zuckerman, MD, FACS · Answer

Hi Katie, thanks for your question.  10 days is still quite early in the post-op period.  It appears that your incisions are healing appropriately for this stage.  While you should consult your surgeon directly regarding his or her preferences, I typically recommend for my patients to begin massaging their scars several times daily beginning at 2 weeks post-op.  I additionally prescribe a silicone-based scar gel, to be applied twice daily for 3 months, also beginning at 2 weeks.  Good luck, and congratulations on your surgery!

Nelson Castillo, MD · Answer

Thank you for sharing your question and photographs.  Based on your pictures alone it appears that your incisions are healing well and without signs of infection.  Continue to keep them covered with clean gauze to catch any discharge and alert your physician in the event of any changes in sensation or appearance.

William Andrade, MD · Answer

Hello, scars are often raised and irregular for 6 weeks or longer after surgery, as the hidden sutures inside the skin dissolve away.  Your surgeon can follow your healing to ensure your scars are fading normally.

Camille Cash, MD · Answer

If you are experiencing drainage from your scars, speak to your surgeon.  There are many scar products on the market.  We have seen great results with Embrace.  Speak to your surgeon about options to consider for scar healing.

Ravi Somayazula, DO · Answer

Based on the pictures you have provided, the incision appears to be healing, however, the scar appears to be wide. If there is persistent drainage at 10 days then your plastic surgeon should have a look at it. Certain postoperative measures such as scar massage or silicone cream or sheeting may help improve the final result of the scar.Best wishes,Dr. Ravi Somayazula

Are my scars healing properly? (Photos)

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