Scarring can act as a deterrent for individuals interested in cosmetic procedures. Various factors can influence how they heal. According to PubMed Central, “age, ethnicity, and a previous history of hypertrophic scars” are all clinical circumstances that play a role in the process. Nevertheless, with the continuous expansion of the medical field, there are numerous ways to minimize or even prevent significant scarring altogether. This kind of treatment can be categorized into two branches: surgical techniques and aftercare.
The management of scarring begins in the operating room. The design of the incision can determine its severity. Traditional incisions follow “relaxed skin tension lines,” indicating a lack of surface tension in the area of skin. This makes it easier for the scar to heal afterwards. Additionally, the type of suture used during the surgical procedure can make an impact. The use of subcutaneous sutures—or fascial tensile reduction sutures, as they are otherwise referred to— allow surgeons to reduce tension on the middle layer of the skin. This acts on the same principle as relaxed skin tension lines, and consequently decreases the risk of pathological scarring. Fascial tensile reduction sutures can be absorbable or non-absorbable because they are within the subcutaneous layer of skin. For facial cosmetic procedures, synthetic and absorbable sutures are preferred. Synthetic sutures limit skin reactions and inflammation. Absorbable sutures are also favored in areas where extensive support is not needed. Furthermore, incisions can be strategically placed to mask any unavoidable scarring. For example, face or neck lift incisions are typically made behind the ear; incisions for cartilage grafts in rhinoplasties are also similarly situated.
However, aftercare is arguably the most crucial aspect of minimizing scarring. Post-surgery, silicone wound dressings prescribed by the doctor are the primary method of preventative scar care. If the incisions do not seem to fade away, though, some doctors have recommended that patients massage their scars after the sutures are removed. The idea behind this practice is that it can help even out the skin surface and resurface red blood cells in the area. In some healing processes, an excess of collagen near the cut may also lead to keloid scars, or raised scars. If a patient is prone to such scarring, surgeons can inject steroids upon request to prevent their formation.
With modern medical advances, patients rarely have to worry about ugly cosmetic results. Modern medicine has advanced to the point where a physician’s care ensures the best-case result for looks, even after major procedures. So, it’s always best to follow any aftercare instructions. Knowing how and why doctors think during this process helps make these instructions more understandable.
References:
- Azmat, Chaudhary Ehtsham, and Martha Council. Wound Closure Techniques, StatPearls Publishing LLC, 2023, http://www.ncbi.nlm.nih.gov/books/NBK470598/.
- Mayo Clinic Staff. “Keloid Scar.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 13 July 2023, http://www.mayoclinic.org/diseases-conditions/keloid-scar/symptoms-causes/syc-20520901.
- Ogawa , Rei, et al. “Clinical Applications of Basic Research That Shows Reducing Skin Tension Could Prevent and Treat Abnormal Scarring: The Importance of Fascial/Subcutaneous Tensile Reduction Sutures and Flap Surgery for Keloid and Hypertrophic Scar Reconstruction.” Journal of Nippon Medical School = Nippon Ika Daigaku Zasshi, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/21551963/. Accessed 28 Dec. 2023.
- Son, Daegu, and Aram Harijan. “Overview of Surgical Scar Prevention and Management.” Journal of Korean Medical Science, U.S. National Library of Medicine, June 2014, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4055805/.
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