Managing your scars Said Plastic Surgery

The process of forming a well-developed scar is called scar maturation, and you can speed that up with a good scar plan. Fortunately now you have one. The time to start is after the incision has sealed itself off, and before the scar has had a change to develop scar problems — about 2-3 weeks after surgery. There are 3 main tools that are effective after surgery to help incisions mature into optimal scars. Generally we like scars that are fine, flat, pale, narrow, painless and soft. For an excellent start on getting a good scar, I recommend using as many of the following as possible for at least a month.

Silicone — Far and away the best proven treatment is applying silicone to the outer surface of the scar. There are a number of forms of it, including silicone ointments which are simple, and silicone sheets which come in many shapes, thicknesses and sizes. All seem to significantly speed optimal scar healing, so use the one that is easiest and works for you. Nothing else you can apply is even close in effect. A number of commonly used products are either ineffective (Mederma) or detrimental and can cause prolonged scar irritation (vitamin E, also listed as tocopherol in many ingredient lists). Any commonly available product that contains silicone will work, and can be easily ordered online. I recommend:

• ScarFade
• ScarAway

Support — Offloading the scar, so it is not being pulled apart, is the best way to avoid a stretched or widened scar. Tape has been shown to be very effective at supporting a healing scar, and preventing scar widening. Of course, tape is irritating to many skin types, so find one that works for you. Leave the tape in place for several days until it begins to peel off, or is just too soiled, and then replace over a fresh layer of silicone. I recommend one of these:

• Paper Tape
• Silicone Tape
• Embrace silicone support dressing

Massage — Compression has been shown to prevent scars from expanding outward, and serves to stop inflammation and scar growth in burn scars. We know it works, but we don't know how much pressure or how long to apply pressure. In severe cases, we use a compression dressing to hold pressure 24/7. It seems to work even with massaging scars several times a day as well. I recommend forming a habit, like massaging for a 60 second count every time you have some privacy in the bathroom. That should typically provide at least 3 rounds daily.