Surgery often leaves scars because the incisions made are deep and dissect the several skin layers. Unfortunately, it is impossible to tell just how bad a scar might be until we actually have sight of it.

A few years ago I had surgery myself which left a big scar on my chest (similar to that  of an open heart surgery scar) as well as some smaller scars on my face, neck and back.

I asked the surgeons, doctors and nurses which scar treatment they recommended but they could not give me a satisfying answer. Actually they didn’t seem to know since the only things they came up with were “you can’t do anything about them” or “Calendulan cream is supposed to help”.

So I did some research. And some more because there’s so much contradicting information on this topic. Eventually, after contacting a private cosmetic clinic I learned which product actually helps surgery scars improve cosmetically. It also reduces itch and pain and prevents excessive scar tissue growth (hypertrophics or keloids).

So here’s a list of surgical scar removal tips based on my research and experiences. It’s about what to do and what not to do, which foods and supplements to take and to avoid before, during, and after surgery to minimize scars resulting from surgery.

Prevention of Surgery Scars

Scar prevention means focusing on certain aspects such as practicing good wound care and not exposing the healing skin to any undue pressure. Other measures may be  harder to accomplish like quitting smoking or losing weight.

In addition to the treatment of scars with topicals such as creams and dressings they can be prevented by dietary adjustments and proper wound care. After all, the quicker and with as less complications as possible, a wound heals the less scar tissue will be formed. This is what cosmetic surgeons and dermatologists advice:

• Blood thinners. Stop taking anything not medically necessary that thins the blood (thus increases bleeding) two weeks prior to surgery. The more you bleed the more swelling and bruising will occur which on its turn will result in larger scars. Substances that should be avoided are; ibuprofen, aspirine, alcohol, garlic, ginger, ginkgo, fish oil, and vitamin E.

• Alcohol. Drinking alcohol dehydrates the body and skin, which prevents wounds from getting the hydration they need to regenerate properly. Avoid alcohol and make sure your diet is caffeine free.

• Exercise. Physical activity that gets the heart pounding stimulates recovery. If your body is in a better shape you will recover more quickly after the procedure. When exercising post-surgery, make sure not to strain the wound.

• Don’t smoke. Smoking reduces the blood circulation, decreasing nutrient delivery that aids healing. Smoking increases the risk of scars and can slow your healing. It’s a significant risk factor and many plastic surgeons will not operate on a patient if he does not quit smoking for at least two weeks before any procedure.

• Protein.  Make sure you eat a balanced diet, but try to emphasize on protein intake. Protein is an excellent nutrient which forms the building blocks necessary to heal skin, so chicken, seafood, fish, pork, or dairy products, are excellent for your health. If you are vegetarian, then soy products make a fantastic alternative as a source of protein. Make sure to eat fermented soy because non-fermented soy can be harmful.

• Weight is an issue when it comes to scarring risks. The fat under the skin works against the surgeon’s efforts to close an incision seamlessly.

 

Post-Surgery Scar Prevention

These are things to keep in mind when the operation has occurred.

• Wound tension. In general, try to avoid excess tension on the wound. Certain body parts, such as elbows and knees, naturally get stretched so tension on such wounds can be reduced by using surgical tape such as . They reduce pulling of the skin and help prevent widening of scar tissue.

• Massage. Gently massaging the fresh scar is thought to stimulate the healing process thus reducing size. It also makes scars softer and more pliable. Scar massage should be done only after the wound has closed and any sutures or staples removed.

• UV radiation. Avoid sun exposure on both wound and scar as much as possible. Use a sunscreen when out in the sun because UV light will make the fresh scar tissue more prominent. Sunlight also dries out the wound and destroys the conditions that are optimum for wound regeneration.

• Hydration is very important to healing skin as lack of fluids can cause heart issues and electrolyte imbalances. If you are well-hydrated, urine will be almost colorless and is a good tip for keeping the right balance for healing.

• Wound care. By practicing decent wound care you are less likely to get an infection which will help your wound close cleanly. If the area around your wound becomes red or feels hot to the touch and perhaps painful or swollen, see your doctor immediately as these are signs of infection and need measures to counter.

• Doctor’s advice. Definitely follow your doctor’s advice after surgery. If he says rest for two weeks, that is exactly what he means. It doesn’t mean, take one week off from your normal duties and then take another week off work and go shopping. Tiring yourself out will not help your wound heal and may cause stress to the wound, and in some cases reopen it. This can also make the wound larger than it should have been, and increases your chance of scarring.

 

The Best Surgery Scar Treatment

After I had to deal with a lot of scars on different parts of my body a few years ago I tried numerous creams, oils, gels, lotions, and even a weekly mud scrubbing scar massage ( a subtle form of dermabrasion). I was determined to get rid of my scars. Or at least improve them to the maximum possible amount. In my experience the silicone sheets (and the gel in lesser amount) are the best scar treatment products.

I learned that flattened and softened my scars to a huge extent. Also the color improved from being very red to a more skin like color.

Confirming my own findings, Wikipedia also states silicone gel sheeting having the most widely accepted role in general scar treatment together with steroid injections. Compared to steroid injections silicone scar sheets and gels are considered less invasive, easier to use and with lower risks of side effects.

Wikipedia also says: “Silicone sheeting technology is used by plastic surgeons and burn centers to provide patients with optimal results. In the past, silicone gel sheets were thick and uncomfortable and susceptible to cracking and breakdown, but newer technologies have improved performance.”

Another great benefit of silicone scar treatment is that it reduces the risk of developing hypertrophic or keloid scars. When it comes to scar treatment products, silicone sheets really are the best buy.

There is scientific proof silicone sheets (or patches as they are called also) work. When searching the Internet for “the international clinical recommendations on scar management” some studies can be found.

Silicone Gel Sheets are Effective

Silicone scar treatment products are in fact the only proven effective over the counter scar treatment products.

Silicone has been proposed as the main form of treatment for both hypertrophic and keloid scars, and has demonstrated significant improvements, even in patients who are prone to abnormal scarring. Silicone sheeting has been shown to reduce symptoms of pruritis and pain associated with scars, and can be used to soften, flatten, and blanch scars to reduce their appearance and increase range of motion by improving scar elasticity (Berman, Brian, et al., November 2007).

In another study, the application of silicon gels showed improvements in redness, itching, texture, and thickness of both hypertrophic and keloid scars in 60% to 100% of the cases (Borgognoni, Lorenzo, March 2002).

 

Silicones Less Invasive and Risky than Alternative Treatments

Silicone elastomer sheeting can be used for the treatment of scars resulting from many types of wounds, including burns, accidental injuries, or surgical incisions. Silicone sheeting is well suited for both scar-prevention and treatment because it exposes the patient to very little risk of adverse effects, which have an infrequent and mild occurrence with this therapy (usually, easily resolvable skin breakdown or rashes).

This contrasts with more complex treatments such as surgical scar-removal, radiation, intralesional corticosteroid injections, and laser therapy. Further, unlike more complex scar treatment therapies, silicone sheeting requires only minimal monitoring by a physician for safe and effective use (Berman, Brian, et al., November 2007).

 

How Long Do I Have to Wear the Gel Sheets?

When I got my silicone sheets I started using them right away for almost 24 hours a day. Sometimes it is recommended to build this up.

Many different treatment protocols for silicone gel sheets have been described in the available literature. Given the variations in these protocols, it is advisable to apply the gel for increasing periods over the course of 1 to 2 weeks until it can be tolerated for approximately 12 hours per day.

It can be a bit of a task to keep the silicone patches attached to the scar. This mainly depends on the part of the body and for example temperature. I tend to sweat easily so this resulted in letting loose of the patches.  They can be affixed with crêpe bandages or silk or paper adhesive tape.

In some sporadic cases people tend to get mild irritations but this can happen with anything that is placed on the body since every individual is different. Such side effects are highly exceptional. I used for the scar on my chest and cut these to smaller pieces for my smaller scars.

 

How Silicone Gel Sheets Work

It is not exactly known how silicone gel sheets act on scars to effect their healing. The silicone gel sheeting works as a water barrier and is also impermeable to bacteria (it does not inhibit or promote bacterial growth). Since the gel has an evaporative water loss approximately half that of skin, hydration may play a role in the healing action of silicone sheeting. But, the silicone itself may also be a factor.

In 1985, one researcher suggested that the low molecular weight of the silicone fluid released from the gel onto the scar surface contributed to the therapy’s success (Farquhar, Kathy, June 1992). The sheets also have high oxygen permeability, and may promote scar improvement through increased oxygen tension and decreased tissue hypoxia in a healing wound. Silicone sheeting may also correct abnormal immunologic processes, which if left unchecked, may alter the tissue repair process and ultimately result in heavier scarring (Berman, Brian, et al., November 2007).

 

Other Post Surgery Scar Treatment Methods

If you are concerned about scarring after an operation, there are some post-operative options (and pre-operative options) available:

• Incision placement – in some cases, the placement of the incision can be altered, so that scars can be hidden or minimized.
• Prescription medication – can sometimes help to lessen scars if your surgeon is willing to prescribe cleansers, ointments or a wound care regimen.
• Steroid injections – can prevent the formation of keloid scars.
• Laser therapy – risk of unwanted side effects.

 

Silicone Scar Treatment Alternatives Known For Side Effects

Traditional methods for treating hypertrophic and keloid scars have historically included techniques such as intralesional injection of corticosteroids, radiation, laser treatment, surgical excision, cryotherapy, and pressure therapy. These methods can be complex and have problematic or adverse effects, so they have usually required the involvement of a physician or medical specialist throughout treatment (Berman, Brian, et al., November 2007).

Beginning in 1982, a new therapy was reported in a journal report by Perkins, Wallis, and Davis about using silicone gel sheets on burns ranging from newly healed wounds to mature scars. These researchers developed treatment regimes for 42 children recovering from burn injuries, in both newly injured patients and for those with scars up to 12 years old. They reported positive results in all 42 patients (Farquhar, Kathy, June 1992).

 

 

References

 

Berman, Brian, et al. (November 2007). A review of the biologic effects, clinical efficacy, and safety of silicone elastomer sheeting for hypertrophic and keloid scar treatment and management. Dermatol Surg, 33 (11), 1291-1303. Retrieved from:

Farquhar, Kathy. (June 1992). Silicone gel and hypertrophic scar formation: A literature review. CAOT & OT Atlantic Conference 1992. Retrieved from: