How Do You Care For Silicone Sheeting On Incisions?

Your surgeon is right to have you protect your incisions from irritation, as that can increase scarring. However, a soft gauze pad can protect your incisions from bra irritation. But if your body has the tendency to form thick or raised (hypertrophic) scars, silicone sheets can help to flatten and fade scars that are ropy, red, and often itchy or painful, so they are not just to prevent irritation.Silicone sheeting appears to work by a number of mechanisms, including contact inhibition of further scar collagen deposition, warmth retention, which increases collagenase activity in the scar (the enzyme involved in collagen breakdown), and moisture retention, another anti-scar mediator. Pressure causing decreased circulation can also reduce scars (we see this in burn patients whose scars are reduced with clear plexiglass masks for facial burns, or elastic gloves for hand burns).Regardless of the mechanism of activity, numerous studies have shown that silicone sheeting does reduce scar thickness and redness, and is the best way to do this. Other proprietary scar products claim wonderful results as well, but fail to stand up under scientific scrutiny as conclusively better than scar sheets. That's not to say they don't work--they simply don't provide a statistically-significant improvement in scar studies.The proposed mechanisms of action are included above so you don't think there is some "special" medicine or medication in the scar sheeting. Over-the-counter scar sheets often tell the patient to replace them daily. As long as your skin and the scar sheeting or scar pads are clean, they are indefinitely reusable. They only need to be kept clean with a little gentle soap and water cleansing (air dry), and they are good as new, including their stickiness, which is not an adhesive, but the silicone itself. They only need to be replaced if they tear or shred. Best wishes! Dr. Tholen

Thank you for your question. Breast incisions can be managed using a multimodal approach:1) Scar massage - starting as soon as the surgical dressings come off and the incisions are sealed2) Silicone sheets or scar gels for about six months to year3) Embrace - a tension reducing dressing for the first 2 months4) Fractionated lasers to help blend the scar into the background - done as a series, starting about 4 weeks after surgery and repeated every four weeks for six months.5) Sunscreen to prevent the scars from darkeningThe main role for silicone sheets is to keep the incisions hydrated during the remodelling phase of the scar maturation. This allows the underlying cells to work in a more optimized fashion. The brand is less important but compliance usually follows ease of use. Silicone usually has less skin irritation concerns with use compared to adhesives. They can also be re-used.  I would wash them gently with warm water and soap.  

Hi Perky,Yes you can wash them with mild soap and water.  Once the adhesive wears off, just hold them on with tape or your bra.  The silicone sheet actually lasts a life time, so to speak, and never loses its effectiveness.  Also keep your PS in the loop. I already know you
are seeing a board certified plastic surgeon because Sientra only sells to BC
plastic surgeons (by ABPS - The American Board of Plastic Surgery)
who are members of ASAPS (The American Society for Aesthetic Plastic
Surgery) and or a member of ASPS (The American Society of Plastic Surgeons). So that is great!  All the best, "Dr. Joe"