Scar healing: Silagen vs Embrace Scar therapy. Which is better?

Question

I am going forward with a breast aug & modified TT. I keep reading that Embrace, albeit very expensive, is the only FDA approved product that proves to reduce tension on scars & minimizes the incision. BUT, I've recently read that Silagen is the "only FDA approved product" that does this, and it's less expensive. Which is better??? I'm a beautiful black woman, and I'm willing to spend the money that will best aide in minimizing the appearance of the scars. Thank you for responding.

Scott Reis, MD · Answer

Thanks for the great question. I feel there is a lot of confusion and misinformation abounding about how to optimize scar appearance. By far the most important factor determining how scars ultimately appear when mature is unfortunately predetermined by your individual genetics. Since there’s nothing you can do about your preset scarring propensity, there are fortunately things that your plastic surgeon and you can do to help optimize the ultimate appearance. 
On your surgeon’s end, using meticulous technique - how the incision is made, using gentle retraction and handling the skin gently during surgery, multilayered closure using the deep layers to take tension off of the skin and properly everting the skin edges - are just some of the methods that allow plastic surgeons to routinely get the best looking scars. 
For things that you can do, there are really only two scientifically validated ways to improve scarring: silicone therapy and UV/sun protection. Silicone tapes/gels/sheeting have a long track record for doing helping with scar maturation and the length, location and mobility of the tissue all determine which silicone product will be easiest to use. Generally you can’t go wrong with a gel though. There are several different gel products available with silicone, Silagen and Biocorneum are two of the most popular - our office sells both. Personally, I prefer Biocorneum since it has several SPF agents included in the gel which is convinient since shielding healing and maturing scars from UV rays is the single most important thing you can do to improve scar appearance (although with an incision under your breast sun exposure likely isn’t a concern - unless you use tanning beds which I doubt). 
I’ve left the topic of Embrace last since it’s very expensive, doesn’t have the same track record as silicone or UV protection and hasn’t been scientifically proven to improve scarring. Plus, with proper surgical and suturing technique like I mention above, the detensioning and eversion provided by the embrace device can be incorporated into the tissues closure anyways. 
So save yourself some money and go with either Silagen or Biocorneum and shield the incision from the sun and UV rays. I hope this helps. Best of luck!(Also any “scar” gels or creams that don’t contain silicone - Vitamin E, mederma, etc - have never scientifically been shown to have a benefit on scarring so are also a waste of time and money)

Larry Weinstein, MD · Answer

I have been recommending silage for over a year with very reasonable results. Use silicone sheeting and gel. follow the directions.

Brian K. Reedy, MD · Answer

Hi! Thanks for asking this question! Use Embrace! I have found my patients who use Embrace have the best incisions. It is worth the expense! Also check with your surgeon to see what he/she suggests. Good luck to you!

Nathan Eberle, MD, DDS, FACS · Answer

Embrace works very well, but is very $$, can cause some rashes while you are wearing it. Moral of the story, the more time your scar is exposed to the silicone in whatever form will lead to a better scar.

Camille Cash, MD · Answer

There are many effective scar therapies on the market.  We have seen good success using Embrace Scar Therapy System.  I encourage you to speak with your surgeon to see what is best for you.

Mark T. Boschert, MD · Answer

Both work great. But any good silicone sheeting and tape will do essentially the same thing. I would not spend the over $1000 for one of those systems. Best of luck!

Gregory J. Stagnone, MD (retired) · Answer

Either is fine and both are very effective. I have seen a study comparing Embrace to topical gel, tape and no scar therapy and it showed some pretty clear benefit but I have yet to see an actual randomized study comparing Embrace with any other brand of silicone strip. Because of cost vs. benefit analysis, I tend to advise any brand of silicone strip routinely but definitely consider Embrace in a patient prone to poor scars or who is developing a bad scar despite our usual efforts. In the end, the vast majority of incisions sewn meticulously with properly timed suture removal will scar beautifully.

Paul C. Zwiebel, MD (retired) · Answer

Generally, the more you expose a scar to silicone, the more you will help optimize the resulting scar.Embrace is pricey, but it does something more than other silicone treatments: Embrace also reduces tension or stretching of the scar. If the cost id not a deterrent, Embrace is probably the best choice to optimize the quality of the scar."FDA Approved" can afford some reassurance, but is not an indicator of relative quality in comparing products

Scar healing: Silagen vs Embrace Scar therapy. Which is better?

Answers (8)

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