Best Scar Therapy Advice?

I'm sure you doctors all get asked this a lot but what's the best scar remedy? I read to apply vitamin e scar guard messages coco butter all sorts of different ways. So I'm a little confused. I haven't been able to ask my ps yet and my consultant didn't give much info. When can I start to apply product? Do I use vitamin E and a scar ointment or just one or the other? Thank you so much for your help and advice and taking the time to answer my question. :)) xoxoxo

Doctor Answers 14

Scar care after tummy tuck

Thank you for your post. In tummy tuck and other lift/tightening surgeries, tension is the enemy. The scar is healing gradually over 12 weeks or so, and until it is strong, it is the weakest link. As there is a great deal of tension in tummy tucks, body lifts, breast lifts, etc., the scar is at high risk of 'stretching' or widening. Silicone sheeting, although having the ability to make a scar flat, does nothing to prevent stretching of the scar. Creams or steroids or lasers also do not have the ability to prevent stretching of the scar. Those are used if scar is thick or dark, but not to reduce the wideness of the scar, which is the main problem. Massage also does not help keep the scar thin, and can actually worsen the scar in the first 12 weeks because you are actually adding tension to the scar. Massage is for softening a hard or thick scar, but if used early, will hasten the scar widening. Only tension reduction has the ability to keep the scar as thin as possible. You may notice in a lot of tummy tuck scars that the center portion of the scar is the widest with the sides toward the hips being the thinnest. This is because the maximum tension is at the center, and least amount on the sides. Embrace removes a lot of the tension by putting more tension on the skin on either side of the incision and drawing the incision together. It is expensive though at about $100 per week for 12 weeks. When patients do not want to spend the money for embrace, I tape the incision trying to remove as much tension as possible for 12 weeks and recommend no stretching back and to sit most of the time, keeping tension off the scar.
Best wishes,
Pablo Prichard, MD


Phoenix Plastic Surgeon
4.9 out of 5 stars 42 reviews

Best scar therapy is to leave it alone.

All of the concoctions you mentioned have no effect on the outcome of the scar. The best thing is to make sure that there is no irritation and let mother nature take care of the healing.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 32 reviews

Best Scar Therapy Advice?

None of these products have been tested in the manner in which pharmaceutical drugs are tested, and few have been compared in studies that would make it possible to answer your question properly.

Most surgeons prefer some sort of silicone based product. Those do require some time to apply, so the thought of using multiple products seems like only someone with nothing but time could consider. You may start once the wound is entirely sealed, with zero drainage. Usually that is true by 3 weeks, but sometimes longer. 

Most patients heal well with no specific treatment. All the best. 

Embrace Scar Therapy is the Best

As plastic surgeons, we get asked frequently what is the best scar treatment.  Through clinical studies, silicone gel as a strip or rub on gel has been shown to decrease the appearance of scars.  For all cosmetic face and breast surgeries, we recommend patients who are 3 weeks out from surgery to apply silicone gel to the incisions twice a day with rubbing it in and massaging the scar.  This should continue until the scar is no longer red, purple or raised which is usually 2-4 months.  For any scar under tension and not covered by the breast tissue, we use Embrace Scar Therapy Pads.  These are amazing.  We use them for all tummy tuck, arm lift, body lift, thigh lift and back lift scars.  They are silicone gel pads that are loaded under tension.  You apply them to wound after 3 weeks of healing.  They are left on for 6 and 1/2 days, then replaced with a new set on the morning of the 7 day.  This is continued for 8 weeks ideally.  The pads are expensive, but the quality of the scar is well worth it.  We actually give them to our patients post-operatively because I am such a big believer in Embrace scar therapy.

Kent V. Hasen, MD
Naples Plastic Surgeon
4.8 out of 5 stars 58 reviews

Scar Management

Regarding the potential for a red raised scar please note the following advice that I recommend to my patient in these circumstances:

Best Scar Management is important to minimize or completely hide from view, the tell tale signs of surgery – namely, scars. Both you and your surgeon want you to have the most minimal scarring possible from your surgery. Patients with scars that are enlarged or not healing well after surgery can be from many causes. Unsightly scars are most commonly due to genetics, underlying medical conditions or improper scar/wound care. The last part is very important and patients can make a noticeable difference in their scars’ appearance by following best scar management practices. Here are some simple tips.

Scar Management tips:
1- Minimize tension on the scar – Steri Strips and/or surgical tape are often placed in non-hair bearing areas to minimize tension and keep pressure over the scar. This minimizes the stress that can pull the scar apart (dehiscence) creating a wound and delaying healing time, and can make the scar wider, or more “ropy”.

2– Keep your incision site/scar clean to prevent infection. Follow your surgeon’s wound care instructions to the letter with out modification. NEVER apply different products then recommended without first discussing them with your surgeon. This is especially important during the first few weeks. If there are any signs of infection contact your surgeon’s office immediately and/or see your doctor or his nurse immediately. Typical signs of infection may include redness outside the immediate incision site, asymmetric swelling, and drainage, of pus, fever, chills, and “feeling sick”
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3. –Protect your scars from the sun - staying out of the sun is the best advice. Minimal exposure to sunlight is prevents hyperpigmentation (permanently turning brown) and other problems that can make the scar more noticeable. Sunscreen, at least 30 SPF and an overlying make camouflage make up additionally protects the scar from the suns harmful rays. This advice is especially important the first year following your surgery.

4. – Use specific scar maturation products recommended by your surgeon. Patients seem to have their own opinions on this touting everything from Pure Vit E, Coco butter, to Aloe Vera, etc but most have minimal benefit other than keeping the scar hydrated. Although hydration is important there are better, scientifically studied products with greater efficacy. Most of the scientific articles written about this subject indicate that topical silicone gel or silicone sheets work the best. There are a lot of products to choose from, but silicone should be one of the key ingredients. Although Mederma, an onion extract derivative active ingredient rather than mainly silicone based may help, primarily silicone based products are better and many also contain other ingredients that may be synergistic (hydrocortisone or other steroid, Vitamin E, Sunscreen,etc). At the present time I prefer BioCorneum or Kelo-Cote products and if the reader has problems obtaining these they can call my office. Patient compliance is also critical – use often and according to directions or it will not work optimally. NEVER apply products without first discussing them with your surgeon.

5. – Monitor to make sure your scar is progressing optimally. Keep your scheduled follow-up appointments with your surgeon to verify that your scars are maturing as expected. Occasionally if indicated you may need a topical steroid preparation or even a series of injections (5-FU and/or Steroids) or laser treatments to treat or prevent scar hypertrophy or keloid formation (red raised scars), or other topical medicines to treat post inflammatory hyperpigmentation (brown scars) with prescription creams and possible laser treatments.

#tummytuck
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#scarmanagement

Scar Management After a Tummy Tuck

You should consult with your surgeon to see what he recommends, as each surgeon will have their own opinions. For my patients, I have them wait until their incision is fully healed, and then I have them use a silicone dressing. Be sure to keep your incision out of the sun for 6 months up to a year! Good luck!

Miguel Delgado, MD
San Francisco Plastic Surgeon
4.8 out of 5 stars 68 reviews

Scar treatment

One of the best scar treatments available for a tummy tuck (which is an incision closed under tension), is Embrace, which is a silicone sheet applied under tension. This is much more effective than regular silicone tape. Silicone gel is ok but not as effective as Embrace. I would not recommend the use of Vitamin E to a newly healing surgical incision. Discuss this in more detail with your plastic surgeon.

William Bruno, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 334 reviews

Scar Treatment?

 

Most of the claims about scar creams, vitamin scar treatments, and "magic scar formulas" are scientifically unsubstantiated and have no validity. Currently silicone sheeting is the most effective product for scar management. Depending on the anatomical area, sheeting is not always easy to use. In that case, bioCorneum®+, a silicone gel with SPF protection has been demonstrated to be effective.  It is important to realize that scarring is dependent on many factors including: the location of the scar, its cause, your general medical health, and your individual ability to heal, which has a significant hereditary component. I would suggest that you discuss your concerns with your plastic surgeon, who should be board certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS).   

 

Robert Singer, MD  FACS  

La Jolla, California

 

Robert Singer, MD
La Jolla Plastic Surgeon
4.6 out of 5 stars 19 reviews

Scar management after plastic surgery

I have tried almost everything out there on patients over the past 20 years and in my experience I think that a relatively new product called Scar Recovery Gel is the most effective product in minimizing the appearance of scars. It is available without a prescription but usually only available through a physicians office. I will usually recommend it for all patients and have them begin applying it to a new healing scar within a week of surgery. Consult with your plastic surgeon regarding specific instructions for your particular case.

M. Dean Vistnes, MD
Bay Area Plastic Surgeon
5.0 out of 5 stars 42 reviews

Post op scar therapies

Thank you for your question.  Each plastic surgeon has their own preferred way of handling scar aftercare.  I am assuming you have already had surgery and wondering how to treat the scar postop.  In my office we like to use paper tape on the scar for 3 months.  I put it on at the end of surgery, we remove it at the 2 week postop visit and the patient starts using it immediately.  The pressure from the tape helps keep the scar flat.  For patients who are allergic to the tape adhesive or simply do not want to wear the tape, we use a silicone based product such as Biocorneum or NewGel which comes as a sheet of silicone or a gel.  I do not recommend Vitamin E.  Do not start any topical treatments until your plastic surgeon advises you the scar has healed enough to start topical treatments.  Hope this helps.  Tracy M. Pfeifer, MD, MS

Tracy Pfeifer, MD
Manhattan Plastic Surgeon
4.8 out of 5 stars 27 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.