Reduce and diminish your scars at Sculpted Clinic

Scarring is an unavoidable consequence of surgery. At the Sculpted Clinic we aim to limit visible scarring as much as possible, be it by hiding them in hairlines or natural skin folds or managing them post-operatively to get the best result.

Wound healing

Following an injury to the skin (in this case surgical incision) there are 4 stages to healing

• Haemostasis. Within the first few minutes cells in the blood of the affected area begin to stick together and form a plug to prevent further bleeding
• Inflammation. Any dead or damaged cells are cleared away by white blood cells.
• Proliferation. Growth of new tissue and vessels occurs with collagen deposition.
• Maturation. Collagen realigns and vessels regress so the scar loses its redness. This process takes up to 12 months.

Factors that may delay wound healing and increase the chance of bad scarring:

• Smoking
• Wound infection or breakdown during healing
• Poor blood supply
• Diabetes Mellitus
• Chronic diseases such as congestive heart failure, renal failure
• Increased age
• Malnutrition
• Alcohol consumption

For the first couple of weeks following surgery, the wound is only at 25% of full strength. Thus the initial weeks are critical in avoiding exercise and tension to the wound. At 6 weeks, the wound is roughly at 80% of full strength. At the site of injury, the skin will never reach full strength.

What can be done to limit scarring?

Tapes are applied to the wound to help relieve tension. These are changed at intervals, but should remain on for 4 to 6 weeks following surgery. It is ok to shower with these tapes and pat them dry after.

Avoid sun exposure to the scar as much as possible. If the wound is on the face or somewhere hard to cover up, start with discreet dressings until sutures are removed and the wound is healed. Once healed, use SPF50+ sunscreen at all times.

Hydration – drinking lots of water is important to keep the skin hydrated and aid wound healing.

Avoid tension or stress to the wound. Exercise should be avoided for the first few weeks following surgery.

Silicone gels or dressings can be applied to reduce the chances of over-scarring, especially in patients predisposed to hypertrophic or keloid scarring. At Sculpted Clinic we advise using silicone after the wounds are healed and sealed, usually at least two weeks post surgery. Silicone can irritate the skin and is best used once the healing process is underway.

After the wounds have healed, around 6 weeks following surgery, massage can be started. Bio oil and silicone gel maybe appropriate for certain wounds and we can recommend these if appropriate. 

What are the types of over-scarring?

As the wound heals, it is initially red and noticeable. Over months, the scar usually becomes flat and pale. However, in certain patients, there can be an overgrowth of scar tissue.

Hypertrophic scars

• Raised and red scar that doesn’t extend beyond the original scar
• The leading cause is tension on the healing wound
• Due to excessive amounts of collagen deposition
• These may resolve over time with massage or require more intervention

Keloid scars

• Firm, smooth growth due to spontaneous scar formation following injury
• In contrast to hypertrophic scars, keloids can extend and grow beyond the initial scar
• This can occur soon after or months later
• Are rare in Caucasians, but increased risk is associated with darker skin, especially Hispanics, Asians and Africans
• May form on any part of the body, but more commonly develop on the chest, ears and shoulders
• Often require intervention to resolve
• Note, these do not change into skin cancers

If I develop a bad scar, what can be done?

• Massage with bio oil. Hypertrophic scars may resolve with massage and bio oil alone
• Silicone gels / dressings. Silicone acts as a tacking substance to help hold wounds together, provides a moist environment and aids the healing process. This can also be used on existing hypertrophic or keloid scars to reduce the scar tissue.
• Steroid injections. Steroid injections into a keloid or hypertrophic scar can flatten the scar and reduce redness.  
• Laser resurfacing. This can be used to both flatten the scar and reduce the redness.
• Surgical scar revision. For keloid scars, this is risky as a new keloid scar can form again and even grow bigger than the previous existing scar you are treating.

Dr Sawhney and our clinic staff will advise you on how to manage your specific wounds dependent on the procedures performed.