How does removing prematurely surgical glue on an incision affect scar outcome?

Question

If a plastic surgeon has used a combination of internal, dissolvable sutures plus surgical glue for a facial plastic procedure, will picking at and removing the surgical glue prematurely (i.e. 4 days after a lip lift surgery) guarantee a result that shows more visible scaring than if this had not been done? Should the patient try to find ASAP surgical glue and put it back on the incision? If so, what brand/type and where is the best place to find it? Amazon.com? CVS?

Randal Haworth, MD, FACS · Answer

I employ surgical glue after breast lifts  and of abdominoplasties since the freshly closed incision tends to ooze blood for approximately 48 to 72 hours. Putting Steri-Strips on the freshly closed incision may trap blood underneath them  necessitating their removal which can  prematurely irritate the skin. Furthermore, glue helps to "lock in" the freshly closed incision from the outside world, potential  lessening the chance of any postoperative infections. The glue  generally  comes off in about a week. If it's obviously peeling like   separating  skin after  sunburn, the glue can be gently peeled away and trimmed. Of course, always consult your surgeon prior to meddling with the fresh incision.

Raffy Karamanoukian, MD, FACS · Answer

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented  scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve  the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture.  Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.
 
Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Robert E. Zaworski, MD (retired) · Answer

If you want a nice result from your surgery follow you surgeon's instructions and do not pick the glue.  See your surgeon for an exam.

How does removing prematurely surgical glue on an incision affect scar outcome?

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