minimize plastic surgery scars

Dr. Mayfield's Six Steps to Minimizing Surgical Scars

Prior to plastic surgery procedures performed by Dr. Mayfield, many of our patients express concern about how much scarring they will have following surgery. To ensure that everything possible is done to minimize postoperative scarring, Dr. Mayfield utilizes a six-step strategy for every plastic surgery procedure he performs.

Remember that all incisions result in scars. The final appearance of a scar is dependent upon a number of factors such as surgical technique, optimal initial wound closure, prevention of infection, appropriate postoperative wound care, avoidance of ultraviolet light exposure, proper nutrition, and even heredity (how you and your relatives have healed in the past), to name a few.

While it is not possible to make any surgery completely scar free, Dr. Mayfield believes that he has succeeded in reducing the appearance of scarring that patients experience following plastic surgery procedures.

The six-step plan to minimize plastic surgery scars includes these elements:

  1. Employ meticulous surgical technique.
    For all plastic surgery procedures, Dr. Mayfield initially plans the direction, length, and location of all incisions in an optimal manner to minimize the appearance of the final scar. He also employs exceptionally gentle tissue handling techniques to minimize trauma and to limit resulting scars. During surgery, Dr. Mayfield uses meticulous technique, multiple layer closures to minimize tension on the skin incision, and very fine surface sutures to limit the formation of unsightly scars. For specific procedures such as breast augmentation (breast enlargement or augmentation mammaplasty) for example, only dissolving sutures under the skin are used, preventing the development of "railroad track" scars that can be very noticeable.

  2. Properly instruct patients prior to their plastic surgery procedure.
    Patients are fully informed regarding the wound healing benefits of proper nutrition and smoking cessation, as well as proper suture line and wound care techniques. Written postoperative instructions discuss topical incision treatment and activity restrictions aimed at ensuring uncomplicated healing and improved scarring.

  3. Personally assess and treat the incision/scar early in the postoperative period.
    Dr. Mayfield personally removes the sutures following all plastic surgery procedures that he performs. This allows an assessment of the quality of the wound closure and the healing progress. Sometimes, all sutures are not removed if there are specific areas that seem slow to heal. Rather than removing sutures too quickly and allowing a slowly healing open wound to result in a heavier scar, removing the remaining sutures after a few more days of healing can result in an improved scar postoperatively. Also, early identification and treatment of any infections or other complications by Dr. Mayfield can minimize the resulting scar.

  4. Prevent early postoperative scar widening.
    Whenever possible at the time of surgical wound closure, or following suture removal, Dr. Mayfield applies 3M™ Steri-Strip™ Adhesive Skin Closures across the suture lines. These strips provide additional wound support that can reduce tension on the suture lines preventing early wound separation and/or scar widening. The outcome is an improved appearance of the scar.

  5. Employ ancillary postoperative scar reduction techniques.
    Massaging the scar during the first several months following surgery, with or without topical vitamin E, aloe, or a moisturizing skin lotion, may help soften it. Topical scar reduction products, such as Mederma and others, may also help to improve the final appearance of the scar. Dr. Mayfield has found that topical silicone sheet application to problem scars may also be helpful.

  6. Avoid ultraviolet light exposure postoperatively.
    Dr. Mayfield recommends that patients avoid ultraviolet light exposure to the scar for at least 2 years by using a strong broad-spectrum sunscreen (SPF factor greater than 30, providing both UVA and UVB protection). This may help prevent the scar from becoming permanently lighter or darker in color than the surrounding skin.

It is important to understand that scars normally become thick, raised, and pink during the first two or three months following surgery, before they begin to soften and fade. Firmness or hardness on the inside under the skin scar is normal during this time, as a result of internal healing. It can take up to 12 months or more for a scar to completely mature. The appearance of the scar will gradually improve while it is maturing, usually significantly so. Surgical scar revision before the scar is fully mature should be considered only in rare cases.

If an individual is unhappy with the appearance of a mature scar, there are laser treatments and a number of surgical techniques that may result in improvement in the appearance of the scar (scar excision and second primary repair, Z-plasty, W-plasty, dermabrasion, etc.). Fortunately, utilizing these techniques to minimize scarring, Dr. Mayfield has rarely been called upon to revise scars after surgery.

 
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