Scars in plastic surgery

Article written by Dr. Julio Terrén, plastic surgeon

Scars are an inevitable aspect of plastic surgery and, in many cases, can cause concern among patients. However, we must understand that scars are a natural part of the body’s healing process, and that there are effective strategies to minimize their appearance and improve their appearance over time.

He Dr. Julio Terren As a plastic surgeon, you find it important to address this issue frankly and provide clear information on how to manage scars before and after a surgical procedure.

Nature of scars

Scars are the result of the skin’s healing process after an injury or surgery. Although all scars go through an initial period of redness, swelling and stiffness, over time they tend to fade and soften.

However, the final appearance of a scar can vary depending on a number of factors, including genetics, incision location, skin type, and aftercare.

Healing phases

Here are the main phases of healing or evolution of a scar after plastic surgery:

1. Inflammatory phase

During the weeks following surgery, the skin experiences a natural inflammatory response.

This phase is characterized by redness, swelling, and tenderness in the scar area. The body sends specialized cells, such as macrophages, to clean the area and remove damaged tissues.

This phase is necessary for the healing process, as it prepares the ground for skin regeneration.

2. Proliferative phase

This phase of healing usually begins around the second week after surgery.

Skin cells begin to actively reproduce to repair damaged tissue. New granulation tissue, which is a matrix of collagen and other components, forms at the site of the scar. Fibroblasts are the cells responsible for producing collagen, the main protein that provides strength and elasticity to the skin.

3. Remodeling phase

This phase begins approximately three weeks after surgery and can last several months or even years.

During this stage, the granulation tissue gradually remodels into a more mature, less prominent scar. Fibroblasts continue to produce collagen, but in smaller quantities, resulting in a flatter, smoother scar.

The scar also undergoes a change in color, going from pink or red to a lighter tone similar to that of the surrounding skin.

4. Maturation phase

In this final stage, which can continue for several years, the scar reaches its final state of maturation.

The scar becomes flatter, whiter and less noticeable as the collagen reorganizes and the skin stabilizes. However, it is important to note that some scars may continue to change over time and may require additional care, such as laser therapy or topical treatment, to optimize their appearance.

During all phases of the healing process, it is necessary to follow the postoperative care recommendations provided by your plastic surgeon. This may include the use of special dressings, topical creams, and massage techniques to promote optimal healing and minimize the appearance of the scar.

Additionally, it is important to protect the scar from the sun and avoid activities that may tighten the skin during the healing process. With time and proper care, most scars after plastic surgery tend to improve significantly in appearance and texture.

Strategies to hide scars

• Advanced surgical techniques: Plastic surgeons use precise surgical techniques to minimize the visibility of scars. This may include making incisions in discrete areas such as natural skin folds, filling sunken scars with lipofilling techniques, using fine sutures, and performing meticulous closures to reduce tension on the skin.
• Topical treatments: After surgery, topical creams or gels may be prescribed to apply to the scars. These products can help reduce inflammation, promote skin healing, and improve the appearance of scars over time.
• Laser therapy: Laser therapy is an effective option for softening and blurring scars. Laser treatments can help stimulate collagen production in the skin, which promotes cell regeneration and improves scar texture.
• Corticosteroid injections: In cases of raised or hypertrophic scars, corticosteroid injections may be given to reduce inflammation and soften the appearance of the scar.

Are scars inevitable?

While it is true that all plastic surgeries will leave some type of scar, their appearance and visibility can be significantly reduced with the proper techniques and treatments.

It is important to have realistic expectations and understand that healing is a gradual process that can take several months or even years. With proper care and post-operative attention, most scars tend to improve over time and blend more harmoniously into the surrounding skin.

It is essential to work closely with the plastic surgeon and follow his or her postoperative recommendations to achieve the best possible results in terms of healing and aesthetics.

Dr. TerrenPlastic Surgeon