Scars are unavoidable consequences of any surgery, but many factors determine how these scars heal and their ultimate appearance.
Scars develop naturally as part of the healing process following surgery or an injury. Their appearance and treatment depends on several different factors; depth and size of the wound, location, your age, genes, gender, and ethnicity. It is important to take into account that once a scar forms it is impossible to completely erase. With good management and treatment though, it can be modified to a more pleasing cosmetic result.
Dr. Samimi plans the surgical incisions so that they will result in the least noticeable scars. During surgery, Dr. Samimi will use different techniques to minimize surgical scars. These may include special sutures, tape and surgical glues.
What should I use on my surgical incisions?
This is usually one of the first questions our patients ask on their preoperative visit. At RevivaMed, we encourage our patients to use topical silicone on their incisions. As silicone tape is difficult to apply and keep in place, we recommend a liquid topical silicone to minimize surgical scars. This can be applied morning and evening, starting two weeks after surgery. It can be beneficial for up to a year following surgery. We also offer microneedling to encourage healing. This can be started in about a month following surgery.
Laser treatments or IPL can also help reduce the redness of a scar.
How would microneedling improve my scars?
Microneedling has the benefit of stimulating collagen and elastin production at an equivalent amount to invasive lasers. Almost all acne scarring, deep stretch marks and surgical scars can be improved after a series of treatments. One of the many appealing aspects to microneedling is the very little downtime following treatment.
How would skin fillers improve my scars?
Skin fillers, either by using your body’s own fat tissue, hyaluronic acid such as Juvederm, or another dermal filler, such as Bellefil, can be used to minimize depressed acne scars. This will require careful evaluation of the scar as skin fillers are best for treating rolling acne scars.
How would chemical peels improve my scars?
This treatment uses a special formulation of chemicals to remove the top layers of skin and is highly effective for mild and pervasive acne scarring. Often a series of chemical peels can produce the best results.
What are hypertrophic scars and how do I treat them?
These scars are raised, red and look similar to a keloid scar, but do not go beyond the scar’s margins. These scars can improve in appearance over the course of one to two years without treatment. However, they can become worse, with itching or pain..Treatments include corticosteroid injections to reduce inflammation and silicone sheeting to flatten the scar.
What is a keloid scar and how do I treat one?
A keloid is a scar that “doesn’t know when to stop” and results from an overly aggressive healing process. The margins of the scar extend beyond the original wound. These scars are raised, irregularly shaped, and continue to grow. These scars do not improve over time. Currently doctors do not know what causes keloids to form, but people with darker pigment are more likely to develop keloids and there seems to be a genetic component. They tend to develop more commonly on the chest, back, shoulders, and earlobes. Surgical intervention can be complicated as keloid scarring tends to redevelop. Corticosteroid injections injected every 4 weeks to 8 weeks can help inhibit the aggressive healing process. In some cases directed radiation, chemotherapeutic medications, and silicone sheeting can be used to reduce the keloid formation.
What surgical options do I have for scar improvement?
This surgical option is most effective for deep acne scars that require a resurfacing that penetrates deeper into the skin that both medium depth peels or a laser. Dermabrasion is also used to improve surgical scars. Dermabrasion uses a diamond-coated wheel to lightly sand the top layers of the skin. This treatment should be done in a surgical facility, under sedation. There is little downtime but redness can persist for several weeks following surgery.
Scar revision surgeries can provide a more pleasing cosmetic result or improve a scar that has healed poorly. The procedure can often done under local anesthesia in the office. Depending on the area, size and width of the scar Dr. Samimi can design a technique to meet your specific needs. Dr. Samimi recommends waiting for at least 6 months after surgery before proceeding with a scar revision as the scars tend to improve with time.
I have acne scars. What can I do for them?
Severe acne scars can persist long after teen years. Treatment of acne scars depends on the type of scar formation.
Boxcar – These can be shallow to relatively deep. They are exemplified by a broad, boxy shape, with sharp edges. Treatment include chemical peels, microdermabrasion, and microneedling.
Rolling – This is the most common with long-term acne issues and present with smooth edges. Unfortunately with rolling scars they usually become more noticeable as you age due to your skin losing its elasticity. Good skin care, as well as skin fillers and microneedling can be the best treatment.
Ice Pick – These are some of the most challenging to treat because they are deeply depressed and narrow. These scars are usually the caused from deep, infected lesions, such as cystic acne. Surgical removal, or treating each scar individually with a TCA peel can get the best results.
Keloid Acne Scars – These scars are very uncommon acne scars and develop with the body’s healing response goes into overdrive. Often injecting these scars with a steroid is a good treatment option.
Hyperpigmentation – Discoloration due to acne healing is a common permanent result of acne healing. There are several options, such as skin peels, IPL (Intense Pulsed Light), and microneedling to help lighten the scarring. There are also some topical skin care creams that can be used to facilitate even skin coloration.