For some unknown reason, patients who will undergo surgery in other surgical branches ask other surgeons, "Sir, how will the scars be left?" even if they were to undergo the same surgery. Will the scar be bad/big? They ask questions like these less frequently. However, we (Plastic Reconstructive and Aesthetic Surgeons) encounter this question very frequently and intensely.
Aesthetic surgery is the general title given to all surgeries performed to make any tissue look younger and/or more beautiful. For the patient who will undergo plastic surgery, the surgeon can make the surgery plan as he wishes. For example; In a patient who will undergo breast augmentation, the scar is hidden by placing it in the fold under the breast or in the transition between the dark colored part of the nipple and the skin (still a scar remains). If the patient does not want scars on her breast, breast augmentation surgery can be performed through incisions made in the armpit or belly button (still scars remain).
For any reason that may cause a health problem; When a biopsy is performed on a mass in the breast due to suspicion of breast cancer, when a mole on the breast is to be removed, "the disease/mass/mole decides" the surgical procedure to be applied to the breast and where the scar will remain. If you enter or remove a mole on the breast from the armpit, or if you cut it off and remove it, in any case, a scar will remain where the mole is. "Aesthetic Concern" should be of secondary importance in surgeries to be performed due to health problems. An approach such as "let's remove the breast cancer but leave no scar on the breast, let's go in from the armpit and fix it from the inside" may make the patient happy for the first 6 months and 1 year, but a recurrence of the disease will be devastating. For these reasons, even if a Plastic Surgeon performs the same procedure, there will definitely be a scar.
As a branch of Plastic Reconstructive and Aesthetic Surgery, all areas except internal organs (heart, kidney, brain, lung, bladder, intestine, etc.) It is a branch that performs surgical applications on tissues. At the same time, it is the only branch that is competent to perform skin reshaping surgery, including during the assistantship process. Skin is the most important barrier between us and the external environment. The body's defense system elements are concentrated most in the intestine, then in the skin. It is also the only organ that can be seen entirely from the outside. For such reasons, Plastic Surgeons have all training and Throughout their development, they worked to leave fewer scars in their surgeries and developed important principles in skin repair.
Let's come to our question; Will there be any scars after the surgery?
Answer; When a damage occurs in any tissue in your body (including the brain, nerves, vessels, eyes, intestines, etc.), this damage is healed with repair tissue and "repair tissue" = "scar". For this reason, if you are going to have any part of you cut off due to plastic surgery, disease-related reason, or if it is cut by accident, "THERE WILL DEFINITELY BE A SCAR." In any interview, if any surgeon tells you that there will be no scars after the surgical procedure he performs, he is simply telling a "white lie".
Let's come to the second and more important question; “How much scar will be left? How obvious will it be? How long does it take for the scar to take its final form?
These questions are more reasonable and logical for the surgeon.
Wound healing, which develops normally and as expected on the skin, is completed within a period of 1 year. While the tissues and cells produced within the healing wound lips are concentrated in the early period (3 months), the tissues consumed or reduced (remodeling) are more after the 3rd month. While the incision scar appears as a straight line in the first month, the incision scar appears as a straight line in the first month. Between months, it is generally red-purple-pink in color and hard to the touch. In the 6-12 months, the redness gradually decreases, the hardness softens, and in the first year it generally remains as a slightly lighter colored, soft line compared to the skin color. This is the process of healing and scarring of an incision during the normal wound healing process. These periods may vary slightly from person to person and from region to region.
Many different factors play a role in poor wound healing. In order not to be full of details, I will talk about the most important issues about what patients can do.
1- You should definitely protect your surgery areas and incision scars (especially in the face area) from the sun. Sun protection should be done not only during the summer but all year round. For protection in the summer, use creams with a high protection factor (50+ SPF/ UVA and UVC protection factors), and in winter, use make-up products or moisturizing creams with a protection factor (SPF 15/ 30). It is important to use it.
2- In the postoperative period, after the stitches are removed, silicone gel application should generally start in the 3rd week, although it varies depending on the region and healing, and while applying silicone gel to the incision area twice a day, 5- It should be gently massaged for 10 minutes. Silicone gels are not intended to prevent scarring, but to prevent the development of "hypertrophic scars" and "keloids", which are wound healing problems, and to accelerate scar maturation.
3- SMOKING! Smoking. There are publications containing different opinions about the effect of its use on the scar can vary, for better or worse. This does not mean that there are fewer scars in smokers. Smoking greatly reduces capillary circulation. The entire skin consists of a network of capillaries. Smoking after surgery will reduce blood flow to the surgery area and cause the repair to be weaker than in non-smokers; Therefore, it will cause the scar to remain wider. At the same time, since flap surgery is performed in many operations of plastic surgery (ESPECIALLY THE FACIAL REGION), it will affect and disrupt the adhesion of the tissues to each other and the remaining of the surgery as it was performed. Taking a break from smoking for approximately 5-6 months, including 2 months before a plastic surgery and 3 months after the surgery (if not quitting ☺ ), will contribute significantly to the results of your surgery in every sense.
The information that is scientifically proven and included in "text-books" is limited to these, and if you pay attention to these issues, you can think that your scar will be healed in the best way possible.
All these matters are necessary. Even if you show sensitivity, healing may still (rarely) result in poor or unacceptable scarring. In these cases, scar/trace revision surgeries can be performed. Rest assured, no plastic surgeon wants to revise a bad scar (for a variety of reasons). For this reason, he performs the repair in the best way possible in his first surgery. However, in some cases, bad/widened scars may still be encountered.
Finally, early diagnosis and treatment of wound healing disorders such as hypertrophic scars and keloids that may develop in the period after your surgery. Visiting your doctor at least twice in a 2-6 month period for treatment can prevent you from experiencing painful and annoying processes in the future to eliminate these problems.
Read: 0
