Why do some patients have scars that fade while others last longer?

Question

I have seen some doctors patients' lose their scars within a year, and others have permanent scarring. But I have noticed those whose scars fade, have shorter incisions, it goes just above the ears along the hairline and that their results do not last past 2yrs. Those with scars, their scars run up higher along the hairline to the forehead but their results last and their facelift is more dramatic, they look younger. Why is this? Also, can laser remove all scarring? Is that always an option

Mehmet Surmeli, MD, FEBOPRAS · Answer

Hi,

Scar healing is a highly individualized process influenced by several factors. Genetics play a significant role; some people naturally produce more collagen, leading to thicker or more pronounced scars.

Skin type and color can also affect scarring—darker skin tones are usually more prone to hyperpigmentation or keloid formation.

It is also known that if the tension of the skin closure is high this may lead to worse wound healing and hence wider and more visible scars. 
Also any problem during the wound healing may lead to more visible scars. Other factors include age, ethnic background, nutritional status, and overall health. Lifestyle choices like smoking or sun exposure can impair healing and affect scar appearance as well.

Additionally, meticulous surgical technique and proper post-operative care are crucial. Following wound-care instructions can promote better healing and lead to scars that fade more effectively over time.

My comments and recommendations are solely based on your text and are subject to change. I always recommend a face-to-face consultation with a specialist to plan the treatment.

Best wishes, Dr. Surmeli.

Ajaya Kashyap, MD · Answer

Thank you for your query. You have several concerns  that I will try to address. 
Scars and their fading with time depends on the technique of surgery, post operative care as well as skin  factors including the type and genetics. The effect and longevity of facelift surgery depends on the layer that the facelift has been performed  rather than the length of the scars. Shorter incision facelifts can work just as well as longer incisions., and last just as long.  Lasers can certainly improve the scars but not remove them. The scarring is usually better when you have a more experienced surgeon working on a favourable skin type and when all postoperative precautions are taken.

Gary M. Horndeski, MD · Answer

When doing a face lift, it is important to hide the scars behind the ear or in the hairline or at the ear-face junction.  This conceals the scars.  Everyone responds to scars differently and there is no guarantee on scarring.

Best Wishes,

Gary Horndeski, M.D.

Ronald J. Edelson, MD · Answer

Patients vary in the scarring depending  on both individual scarring and the technique used by the surgeon. A good surgeon will know how to make the scarring as unnoticeable as possible

Zoran Potparic, MD · Answer

It is true that patients show lots of variety regarding the length and type of scars. Although it usually takes a year for scars to mature in the age after 40, some patients have much longer scar maturation process. Most of the scars hidden in the hair, in front and behind the ear,  are barely visible but in some patients, stretched, wide scars are reality. Unfortunately it is impossible to predict exact healing/scar making pattern in all patients. Hope this helps.

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Why do some patients have scars that fade while others last longer?

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