If you are going to get a keloid scar, when does that start to develop and how long should you wear silicone strips? (Photo)

I have been studying the silicone gel and its mechanism of action since 1989 when we published the first article that showed a clear benefit for silicone gel in the treatment of scars, and my group has published many papers since that time..  Going back to our original papers, the beneficial effects were seen almost entirely in the first 2 months of use.  Many now recommend longer use, but there is no firm data to support longer use.  True keloid formation can occur even years after surgery, but keloids are rare compared to hypertrophic scars which are ropy and raised, but do not extend like a tumor beyond the original scar.    Your scars are mildly hypertrophic, but unless you have a previous history or family history you are not at risk for keloids.  I think your surgeon gave you good advice and you should be fine.

Thank you for posting your photos. There is a difference between Keloid scars and Hypertrophic scars. Keloids scars are less common and they grow excessively to extend beyond the original scar. Most patients experience hypertrophic scaring rather then Keloids. A Hypertrophic scar is basically a raised scar. It can feel "rubbery", but not as hard to the touch as keloids and they do not grow beyond the original scar. Prevention and treatment of hypertrophic cars is much easier. I usually recommend patients start using silicone strips 4 weeks after surgery for about 12 hours a day. They can continue to use them for about two months if necessary. If you do not have personal or family history of keloids it is highly unlikely you will ever suffer from keloid scaring. It seems your scar is healing fine. You might have some mildly hypertonic portions, but these should respond well to the silicone strips. Best of luck on your recovery!Dr. Miguel Mota

Silicone-based strips and liquids are the best studied scar treatments. These are most effective in the first 8 weeks following surgery. There is less evidence as to efficacy beyond the 2 month point- although it is safe to use them longer. While most people will heal with favorable scars, thick and ropy scars can occur. If the form, there are lots of options to improve the final results and should be discussed with your surgeon.

Thank you lvmom42 for your questions and congratulations on your surgery.  You scarring looks amazing.  I typically don't recommend silicone strips but do recommend Biocornium cream to be used for about 6 months and massaging the area.  It's a scar cream that will help keep the scar soft and help it from developing a dark color.  Scars take about 1-1.5 years to mature fully.  Each surgeon has their own protocol to follow so I would suggest speaking with your surgeon to see if they recommend anything additional to do.  Best of luck to you. 

Thanks for the question.  All of the data for silicone sheets supports their use for two months after surgery.  Use for longer than that does not result in scar improvement.  You do not appear to have any keloids based on the appearance of your scars in your photos.  That being said, you can use the sheets beyond the two months without any detrimental effects on your scar.  Some patients prefer to continue using the sheets to avoid any shearing forces and rubbing on their scars. 

Dear Lvmon42,



Keloids can be very unpredictable.  I have seen some start to form after only a few weeks and I have also seen perfectly good scars for six months then start to keloid.  I think the silicone gel tape can still be effective if you are really concerned.  I hope this has been helpful.
  Robert D. Wilcox, M.D.

Dear Ivmom42,
scars naturally get thicker for the first 3 months and judging by your scars they are a little hypertrophic (thickened) so I would recommend you continue with the silicone strips or try the gel for the full 3 months. Your scars do not look keloidal so don't worry about that. You can continue the silicone until the scars are flat, after that they won't improve the scars. 
I'm sure the scars will flatten.
Regards,
Richard Baker