Plastic surgery, otherwise referred to as cosmetic surgery, is growing in popularity. Numerous plastic surgery procedures are now safer, with more reliable results and higher patient satisfaction rates. The media have highlighted the role social media has played in the rise of plastic surgery and research has also shown that the popularity of selfies, has made many individuals more self-conscious of how they look in photos. In addition, since the start of the coronavirus pandemic there has been a significant increase in the need for video calls and online webinars, which has been suggested as one of the reasons the demand for plastic surgery continues to increase, despite the ongoing pandemic.
Worldwide, including the UK, USA and Australia, any registered surgeon can perform plastic surgery. Normally referred to as cosmetic surgeons, with the exception of surgeons that focus solely on ear, nose and throat (ENT) surgery and oncoplastic breast surgeons, the skill of surgeons that have not completed specialist plastic surgery qualifications is questionable. With regards to any type of plastic surgery procedure I would always recommend checking that your surgeon is registered with a recognised medical body as a plastic surgeon, proving they have completed specialist plastic surgery training and assessment.
Check worldwide professional bodies for plastic surgeons.
One of the main considerations for plastic surgeons is where the incisions are placed. All surgical incisions will leave a scar and ensuring they are located where they will be naturally hidden and are as fine, flat and close to the nearby skin colour, as possible, is the goal of all surgeons. There are various treatments and products that claim to help support the healing process and improve the final appearance of the scar when used after the stitches have been removed. The processes that occur during wound healing are commonly separated into three stages, known as, inflammation, proliferation, and remodelling.
Supporting wound healing for a better scar
The most important factor that can negatively impact wound healing is prevention of an infection. Keeping the wound clean, and changing the dressings when they become saturated, is essential to keep out bacteria which could lead to an infection. Scar treatments should not be used until the stitches have dissolved or been removed, as advised by your surgeon. The application of scar treatments during the remodelling phase combined with the correct massaging techniques has been shown to decrease scar formation and improve the final scar.
Numerous external factors can affect the healing process and the resulting scar. These include, but are not limited to, health conditions such as diabetes, medications, alcohol dependence and smoking prior to the procedure. In addition, good nutrition and taking supplements have been linked to faster healing and less noticeable scars. For the purpose of investigating scar treatments, I will only be referring to healthy, non-smoking patients, without alcohol dependency.
Precise techniques during the creation of and the sealing of the incision, are essential to reduce skin tension which can cause raised, wide, uneven scar formation or even contribute to the development of keloid scars. Regardless of how skilled your surgeon is, the way you care for the skin as it heals is important.
‘Studies have shown that maintaining hydration and allowing healing to occur in a moist environment can be beneficial for healing and reducing scar formation.’ 1
Among the various choices of scar treatments, many plastic surgeons now consider silicone gel sheets the ‘gold standard’. This article investigates if a combination approach could be equal or superior to the benefits provided by silicone gel sheets alone; when applied to a post-operative scar following the removal or re-absorption of dissolvable stitches.
Scar treatments for a better scar
One combination that has been shown to help reduce the formation of wide, irregular, raised and discoloured scars is the use of micropore tape and silicone gel scar treatments. The micropore tape helps to reduce tension on the scar for the first three to six weeks and is followed by the use of silicone gel sheets for twelve hours a day, for up to six months. This combination is the standard scar treatment regime recommended by numerous surgeons. Gentle scar massage with petroleum jelly is also advised to aid the formation of a supple, softer, flatter and finer less noticeable scar. This is often recommended in between application of silicone gel sheets for twelve hours a day.
Research into the effect of onion extract contained in a product called Contractubex® has demonstrated improvements with the final healing and look of the scar. Another new topical silicone based gel called PracSil, which contains pracaxi oil, has also been shown to aid healing and the final appearance of the scar. However, evidence is still not clear into whether this added ingredient has an active effect on scar formation or if the improvements are due to the moisture provided by the application of the silicone gel.
Another relatively new product is CicaLux Energized Scar-Care – a combination therapy device that provides moisture, pressure and heat to the scar tissue. This scar treatment comprises a CicaLux silicone sheet, CicaLux Tapes and a CicaLux stone. The silicone sheet works in the same way as other medical grade silicone gel sheet scar treatments, by reducing transdermal loss of water, decreasing itching and scar discolouration.
When the disposable CicaLux tape is applied over the CicaLux silicone sheet, the combination helps to reduce tension on the scar while also applying pressure to the scar tissue. In addition, the breathable cotton tape prevents the build-up of excess moisture, which can negatively impede scar healing. The CicaLux stone pops into the silicone sheet and is used to deliver infrared heat that increases blood flow, key to the healing process. The CicaLux stone can also be used separately to massage the scar, helping to further flatten and soften the scar tissue, leading to a finer scar that is more difficult to detect.
In conclusion, the use of combination therapy is highly recommended for improved scar outcomes, and the benefits provided by the CicaLux combination therapy device certainly show promising results. In addition to scar therapy product use, avoiding sun exposure on the scar for the first eighteen months is vital to reduce the chance of the scar becoming thicker and discoloured.
- Traci A. Wilgus, Inflammation as an orchestrator of cutaneous scar formation: a review of the literature https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7592345/
About the author:
Annabelle Bough has had numerous plastic surgery procedures including breast augmentation, rhinoplasty and liposculpture and writes regular blog posts about advancements in plastic surgery. She wants to make it safer to find a qualified plastic surgeon online. Her website features a consultant register and she checks the qualifications of every consultant on a rolling 3 month basis.
Resources: Update on Postsurgical Scar Management
Sarah Jane Commander, Edward Chamata, Joshua Cox, Ryan M. Dickey, Edward I. Lee
Semin Plast Surg. 2016 Aug; 30(3): 122–128. doi: 10.1055/s-0036-1584824
Plast Aesthet Res. 2020; 7: 54.
Published online 2020 Oct 16. doi: 10.20517/2347-9264.2020.150
A comprehensive evidence-based review on the role of topicals and dressings in the management of skin scarring
G. P. Sidgwick, D. McGeorge, A. Bayat
Arch Dermatol Res. 2015; 307(6): 461–477. Published online 2015 Jun 5. doi: 10.1007/s00403-015-1572-0
Disclaimer: This sponsored article provides general information and discussions about health and related subjects. The information and other content provided in this article, or in any linked materials, are not intended and should not be construed as medical advice, nor is the information a substitute for professional medical expertise or treatment. If you or any other person has a medical concern, you should consult with your health care provider or seek other professional medical treatment.
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Click here if you want to check out Before/After scar photos