Photo: sasirin pamai (Shutterstock)
All surgeries, whether medically necessary or cosmetic, have something pretty big in common: You’ll be cut into, even if only a little bit. Incisions leave scars which, if you’re focused on preserving your health or accomplishing a goal, might not be that big of a deal to you in the moment. Still, if you’re worried about some unsightly scarring resulting from a surgery, you have options before and after your procedure.
What is a scar, really?
You might be wondering why your body can’t just heal by growing regular skin where your incision was made. That’s a fair question. To understand what scars are all about, Dr. Jacob Haiavy, former president of the American Board of Cosmetic Surgery and the California Academy of Cosmetic Surgery, explained: “Scars are a natural part of the body’s healing and repair process. When the dermal layer of skin is damaged (either by accidental injury or an intentional/surgical incision), the body forms new collagen fibers to mend the damage.”
He said the new scar tissue that forms usually has a totally different color, texture, and quality than the tissue around it. The ultimate look of your scar will depend on a number of things, like how much collagen your body produces, which is influenced not only by genetics, but by age. Your physical health, your surgeon’s techniques, and your postoperative care also determine how it will look. In short, there’s a lot going on here—but there are also ways to influence those factors.
How to prep your skin before your surgery
Even before your big day, you can take some steps to make sure your skin is healthy and ready to be snipped, pulled, sutured, and otherwise (safely) violated.
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“Before surgery, commit to healthy lifestyle choices, such as avoiding smoking, drinking plenty of water, and eating well,” said Dr. Kevin Duplechain, a triple board certified surgeon in Lafayette, La. “The right skin care before surgery, along with postoperative skin care, is essential in reducing the appearance of scars.”
Haiavy seconded those recommendations, adding it’s also important to choose a reputable surgeon—provided you have the opportunity to pick. Of course, there will be times when a patient has to have an unexpected surgery or a health problem has to be dealt with immediately and locally. Still, if you do have some time, you should research surgeons and never be afraid to ask them questions about their techniques and recommendations. (Here are some other tips for prepping for a surgery, including what other questions you should ask.)
What can you expect of your scar’s appearance right away?
Scars change their appearance over time as your incision heals and depending on your aftercare. Haiavy said scars will be very pink on the first day, with some scabbing similar to what you’d see after an accidental injury. Some surgeries require work deeper within the body and, depending on the procedure, your scars may be supporting new tissue or other heavy things. The scar of an incision over an implant of some sort, for instance, will look different and take longer to heal.
In the first week, scars will be tender. Your surgeon will tell you how to clean the area and whether you have dissolvable sutures or ones that need removal. You might have Steri-Strips or butterfly bandages over your incision, too. Those are thin bandages that can be used as a backup to dissolvable stitches or even after your stitches are gone. Keep those on until they fall off on their own, and go over best practices with your surgeon. Listen carefully to any instructions you receive—and if you don’t get any instructions, ask. Proper aftercare and suture removal is important not only for the appearance of the area, but your health and recovery overall.
“After a few weeks have passed, your scars will still look pink but will typically be completely closed, allowing you more ease in bathing,” he said. “At this point, you can also use makeup for coverage. However, incisions should be still delicately treated for the coming months, as any strain may widen the appearance of the scar.”
If your surgeon recommended any postoperative support garments, wear those. They might be uncomfortable, but they serve a number of purposes, from reducing swelling to helping your weakened skin heal. After a breast augmentation, for instance, you are asked to wear a front-closure bra that looks similar to a sports bra to prevent strain on the scars.
Haiavy and Duplechain were both adamant about avoiding the sun, too. UV rays and sun exposure can lengthen the time it takes your scar to mature and can even permanently darken and discolor the tissue. During the first six months after surgery, use a bandage or opaque clothing to cover the site. Always use a sunscreen of SPF 30 or higher (in general, but especially now).
How to care for your scar after surgery
Duplechain warned that though there are numerous “scar creams” on the market, you shouldn’t just load those into your Amazon cart and call it a day. Your surgeon should instruct you on caring for the scar with creams and moisturizers after about two weeks. Again, if they don’t, ask.
Don’t use harsh skincare products or makeup until you’re fully healed. Duplechain even said you should review all the ingredients in your skincare with your doctor or nurse. Rather than investing in unproven creams, he added, stick with “the only product that has proven to be effective in studies”: silicone-based sheets, strips, or gels. Your surgeon can probably get you some and you can find them over-the-counter, too.
“Unlike creams, these products physically support the scar—holding the two sides of the incision together to help you achieve a nearly invisible, hairline scar appearance,” he said. “Silicone has been shown to inhibit scar formation by slowing down fibroblast activity (cells that make collagen and scars).”
He also suggested lymphatic drainage massage, which has been shown to accelerate healing by promoting blood flow to the area, and being mindful of the ways in which you move your body. Stretching or straining at the incision site can add pressure there, widening your scar. In other words, take it easy.
Can anything be done about a scar’s appearance once it’s healed?
The appearance of older scars can also be improved, too, with certain treatments. Duplechain said, “Although scars can never be completely removed, they can be improved to look narrower, smoother, softer, and overall less noticeable. I’d recommend a thorough consultation with your doctor to find the most appropriate treatment or procedure for your case based on the size, color, thickness, and location of your scar.”
Here are a few of the treatments you can consider for reducing the appearance of scar tissue:
Steroid injectionsRadiotherapyDermabrasion and microdermabrasionLaser resurfacingFiller injectionsMicroneedlingCryosurgeryScar revision surgery, including skin removal or graftingOr just leave your scar exactly as it is—it’s a part of your journey and maybe even gives you a story to tell.
