Surgery leaves scars. That’s almost inevitable. Sometimes surgeons can place incisions strategically to reduce their visibility but most of the times scars will be in plain sight.
If a surgeon makes rough cuts through the layers of skin, or makes a deeper incision than strictly necessary, the scar is going to be bigger and will take longer to heal. As a result the chance on abnormal scarring (e.g. keloids) will increase.
Such less ideal performances may for example happen during emergency surgery when the surgeon(s) are trying to safe someone’s life or when hasty action for other reasons is necessary.
Coping with a surgery scar
Of course when looking back it is reassuring to be able to conclude the surgery was successful. It can nevertheless be hard to cope with the fact that you will have to live with a scar.
In fact it is very common for people to worry about the cosmetic appearance of their new to form scar.
Post-surgery scar treatment recommendations
When asking their surgeon for clarity or support regarding optimal treatment they often meet with incomprehension.
Many surgeons, as it turns out, are seemingly not that concerned with the cosmetic aspects of their performance (plastic surgeons aside).
Although it has to be admitted, surgeons are increasingly willing to advice patients about follow up scar treatment.
How a scar forms after surgery
How a post-surgery scar will develop depends per person and per situation. The following aspects influence how much scar tissue will form:
- The quality of the surgical technique,
- genetic predisposition to improper wound healing, and scarring,
- general health of the patient
- and the location of the wound determine the outcome of the scar.
Generally, scars above moving joints, or on thin skin with less tissue, such as the collar bone or chest bone, are the most problematic.
Scars form when the outer layer of the skin, the epidermis, and the lower layer, the dermis, are punctured. Which obviously, is the case during surgery.
During the healing process, cells known as fibroblasts, responsible for repairing ruptured skin layers often react excessively. the body overproduces collagen, which causes the scar to be raised above the surrounding skin.
The typical surgery scar
When excess collagen is created after the wound has closed we speak of hypertrophic scarring. These scars are often red or purple colored and raised.
Hypertrophic, means enlarged or overgrowing. These scars are the typical red or purple raised scars that most of the times fade within a year to 18 months.
Although automatic improvement is common, not all scars fade. Sometimes keloids form. A type of hypertrophic scar that grows beyond the boundaries of the wound.
When to use scar cream after surgery?
It is normal to be preoccupied with the surgery. As a result the question which scar cream is best to use after surgery may not rise until the moment is there.
For optimal results it is best to start with scar treatment at the moment the wound has healed. Enhancing the wound healing process can be very beneficial and reduce the risk on unsightly scarring.
More about how to care for your surgery wound in a bit.
Efforts to improve the look of scars are most effective in the first 6 months. So for optimal results, start with treatment right after the surgery wound has closed.
Which scar cream is the best to use after surgery?
Almost all experts, dermatologists, plastic surgeons, and other medical professionals agree that silicone gel is the best over-the-counter scar treatment to use after surgery.
This type of scar cream is not only recommended by plastic surgeons but is also the only clinically proven home remedy. Various studies conclude that:
“Silicone materials have proved to reduce the amount of scar tissue and are believed even to prevent hypertrophic scar and keloid formation.” (1)
The Journal of Plastic Reconstructive Surgery recommends silicone gel sheeting for the management of a wide variety of abnormal scars. The researchers state:
“..that these are the only treatments for which sufficient evidence exists to make evidence-based recommendations.”
The Aesthetic Surgery Journal concurs. They published an article comparing the effectiveness of silicone sheeting with silicone creams and herbal scar treatments for scars. Silicone gel sheets came out on top, by far.
Silicone sheets (solid) can be cumbersome to keep attached. In that case silicone creams are more convenient.
How to optimally care for your surgery wound
To some this may come as a surprise but you should not let your wound dry in the air. Scabs interfere with wound healing. As a result more scar tissue will form.
‘A scab will create a barrier to healing,’ says expert in scars from the University of Wisconsin, Kim Rock Stockheimer.
It is recommended to keep a wound moist and covered. This way you create an ideal healing environment.
Various types of wound dressings are specifically designed for this purpose. Which dressing is best depends on the type of wound and for example the amount of wound fluid exudate.
Moisturized skin improves wound healing and ensures a balanced release of collagen. Hydration is also how silicone sheets work on scars.
Read this post for more tips on how to treat your wound and reduce the risk on scarring.
‘The aim is to keep the wound moist and thereby keep the collagen away from the surface of the skin.’