Is using silicone gel covered by silicone sheets covered by medipore tape overkill for scar treatment?

Question

I’m 2 weeks post breast lift with implants and got the ok to remove steri strips and begin scar treatment per Md. He recommended Pro-sil, a glide on silicon therapy with SPF. It seems like I should be doing more. I’m still wearing my post surgical bra for support. Will using the medipore tape over the silicon gel and sheets help relieve more tension on the suture lines? Or could I risk widening the scar line if not placed correctly?

Kenneth Hughes, MD · Answer

In general, scarring is a product of genetics. Some people are good scar formers and others are poorer scar formers. There is no one best therapy for scars. Silicone sheets, Mederma, and Biocorneum are reasonable and popular options. I recommend that the scar therapy begin after the scars have healed and there are no open areas, which usually takes 4 to 6 weeks.Follow the protocol of your PS as this is very individual, and each plastic surgeon has his or her own ideas based upon experience.

Robert M. Tornambe, MD · Answer

LovelyLadies24. I appreciate your determination and dedication, however please do not go overboard! Gel sheeting is an excellent option for scar care, and further taping concurrently is not necessary. I recommend that you check in with your plastic surgeon and follow advice about scarring and recovery. Good luck.

Daniel Barrett, MD · Answer

Dear LovelyLadies24,for scars, I close all of my incisions in 5 layers and do not use absorbable sutures because they cause inflammation and worse scarring. I tape all of my incisions in the office visits once a week for six weeks after surgery to improve the appearance. After taping, I start my patients on a scar gel therapy for 3 months that they have to put on their incisions twice daily. But every plastic surgeon has his own postoperative protocol which he recommends to his patients. I would suggest you to discuss this with your plastic surgeon.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Dallas Buchanan, MD · Answer

Thank you for your question. In short, the answer is yes. Adding additional bandages with silicone on top of other silicone bandages is defeating the purpose. One layer of silicone in contact with the skin and the scar is sufficient for scar management. Also, I would not be fooled into thinking that the silicone sheets are offloading tension, as they are not. The only device on the market that I trust to do active tension offloading is called Embrace. You can look into that as an option if you want to do the most possible for your scars as they heal. Discuss your options with your plastic surgeon.Hope this helps!Dallas R. Buchanan, MD, FACSOwner & Board-Certified Plastic SurgeonVIVIFY plastic surgery

Scott R. Brundage, MD · Answer

Anything that you put on topically to a scar will not prevent it from spreading. Topical items will typically just keep the scar from getting hypertrophic (thicker). To keep a scar from spreading takes keeping the tension off the scar. Doing such things as long term taping usually works best.

Nidia H. De Jesus, MD, PhD · Answer

Thank you for your question.
While evidence suggests there is a benefit to silicone-based treatments for improvement of scars, adding medipore tape over silicone gel/sheet may not be any more beneficial that use of silicone gel twice daily or silicone taping alone, and may actually cause irritation. I would caution you and advise you to check in with your plastic surgeon regularly to ensure that he/she continues to monitor your progress and that healing is as expected. 
Best wishes!

S. Tyler Elkins-Williams, MD · Answer

There are many methods for scar management; you should first know that most of them are based more on a surgeon's experience and opinion than rigorous evidence. But that's ok! It can be very hard to design a good study for scar management, both because scars will improve with time naturally, and because variations in patient factors and surgeon techniques can contribute to aesthetic healing as much or more than post-op scar treatments. So most surgeons have settled on a post-op protocol that they have found works for them. What works for one surgeon may not work for another, based on slight differences in other factors. 
Silicone actually does have good evidence about its use in minimizing scars after surgery. I don't personally think that use of a gel plus a silicone sheet is helpful - it is the layer of silicone next to your skin that matters. Adding a second layer probably doesn't hurt anything, but it's wasting your money. I'd say the same thing about Medipore tape. Applying it after the silicone gel has dried isn't like to hurt anything, though it could irritate your skin to apply/remove it constantly. 
Silicone does NOT offload tension on the scar. If your surgeon is telling you to use it, that means that he thinks the incision has healed well enough to no longer need Steri-strips or Medipore tape to help relieve tension. The silicone is there to help the scar flatten and appear less red. Overall, I'd recommend discussing any post-op incision management with your surgeon - he certainly wants your incision to heal well also!

Robert L. Kraft, MD, FACS · Answer

The only treatment can have a positive effect is the one adjacent to your skin.  The others will do nothing. Follow your surgeon’s recommendation for scar control. I know that patients want to feel that they are “doing something” but scars have to heal and you have to have patience during the year in which this occurs.

Robert E. Zaworski, MD (retired) · Answer

Scarring is a product of genetics. Some people make good scars and others, not so good. There is no one best therapy for scars. Silicone sheets, Mederma, and Biocorneum are reasonable and popular options.  I have found through the years that taking vitamin E by mouth on a daily basis seems to work better than anything you rub on it.  If you do rub the scar, be sure to rub it in the direction that it is going.

Is using silicone gel covered by silicone sheets covered by medipore tape overkill for scar treatment?

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