Surgical Scars - Care and Minimisation Techniques

Treatment Options for Scars after Plastic Surgery

Surgery is a big deal, and after all the planning and anticipation, you’re left with a reminder of the procedure: surgical scars. Scars aren’t bad—they’re a part of how our bodies repair themselves. However, you may prefer your scar to heal subtly, blending into your natural skin tone and texture.

After surgery, the body naturally works to close and repair the wound, creating new tissue and using collagen to fill in any gaps. This process often leaves behind scar tissue, which can be thicker, lighter, or darker than the surrounding skin.

Sydney Specialist Plastic Surgeon Dr Jake Lim shares his advice on how to support the healing process and guide your scar toward a smoother appearance.

Healing Process after Surgery

The process of scar formation happens in three main stages, and each step plays a part in shaping how the scar looks and feels. Getting familiar with this process can help you know what your skin needs:

Inflammation Stage: This is the body’s initial response after surgery. Your skin starts by delivering extra blood to the wound, which brings cells to start the healing process. You may notice swelling, redness, and some warmth around the area, which is all normal.
Tissue Formation Stage: In this stage, collagen production ramps up to form new skin tissue. Collagen, a structural protein, is essential for filling in the wound, creating a protective layer to close up the incision.
Remodelling Stage: Over the following weeks and months, the body begins to remodel the new tissue, making it softer and more flexible. This stage is where your scar becomes “mature” and starts to look more like the surrounding skin.

As your scar moves through these stages, adjusting your care to fit each phase can make a difference in its final appearance.

Best Practices for Initial Wound Care

The first few weeks post-surgery are a crucial time for setting up your scar for the best possible healing. Here’s what to focus on:

Cleanliness and Protection: Gentle cleansing with mild soap and water keeps the wound clear of bacteria. Avoid scrubbing the area; instead, pat it dry with a soft towel. Clean, dry skin is less likely to develop complications. Check with Dr Lim when you can get your wounds wet.
Dressing and Bandages: Follow Dr Lim’s advice on how long to keep the area covered. A fresh bandage not only keeps out bacteria but also prevents the scar from drying out, which is important in the early stages of healing.
Avoid Stretching or Pulling: Be mindful of any movements that might stretch the scar. For instance, if the incision is near a joint, avoid excessive bending. Stretching can widen the scar, so try to keep the area as relaxed as possible during these early weeks.

A gentle start with cleanliness, protection, and minimal movement gives your scar the best chance to heal smoothly.

Breast Reduction Patient 23 — Front View

Daily Scar Care Routine for Minimisation

Once your incision has fully closed, establishing a daily care routine helps prevent scar tissue from becoming too obvious. Here’s a simple plan to keep things on track:

Gentle Cleansing and Moisturising: Start with a mild, fragrance-free cleanser to keep the area clean without drying it out. Afterward, apply a hydrating, fragrance-free moisturiser. Regular moisturising keeps the skin supple and can reduce the scar’s tendency to dry out or become rough.
Sun Protection: Sun exposure can darken scars and make them stand out against your natural skin tone. Protect your scar with an SPF 30 or higher sunscreen. Even if it’s a cloudy day, covering the area with sunscreen can prevent unwanted pigmentation.
Silicone Sheets or Gels: These products are popular for their ability to flatten raised scars and make them softer. Silicone works by creating a protective barrier over the scar, allowing it to retain moisture. Start using silicone sheets or gels once the wound has closed and wear them consistently for best results.

These daily steps help support your skin’s recovery, encouraging the scar to heal in a more uniform, natural way.

Scar Massage Techniques

Scar massage is a simple, cost-effective way to encourage smooth, flexible healing. Massaging the scar a few minutes a day helps prevent stiffness, improve blood flow, and break down any thicker scar tissue.

Why Massage Helps: Massaging promotes circulation, which brings oxygen and nutrients to the scar tissue. This supports healthy tissue development and can make the scar feel softer and less tight over time.
How to Massage Safely: Use two fingers to gently press down on the scar and move in small, circular motions. Keep the pressure light, especially in the beginning. If the scar feels tender, use even lighter pressure, and work up gradually.
When to Start: Generally, you can begin scar massage a few weeks after surgery, once your surgeon confirms it’s safe. Some people find that a few minutes each day over several months can make a noticeable difference.

Taking just a few minutes each day to massage the area can have lasting benefits for flexibility and appearance.

Topical Treatments for Surgical Scars

Adding a topical treatment to your routine can provide extra support in softening and smoothing out scars.

Over-the-Counter Creams and Gels: These often contain ingredients like vitamin E, or aloe vera, which may help keep the skin soft and hydrated. Aloe vera, for instance, is known for its soothing properties, and vitamin E is popular for skin hydration.
Customising Your Choice: Different scars respond differently to treatments, so don’t worry if you need to try more than one option. Pay attention to how your skin responds, and consult your surgeon for advice on what may work best for your specific scar.

Choosing the right topical can be a trial-and-error process, but when you find a good match, it can significantly enhance your scar’s appearance.

Advanced Scar Treatment Options

When aiming for refined scar minimisation, advanced medical treatments offer effective options, each tailored to suit specific scar types and skin needs. Here are some professional treatments that can help smooth, soften, and reduce the appearance of scars:

Laser Therapy for Scar Reduction

Laser therapy is a versatile and widely used option for scar improvement. Different types of lasers are available, each with unique properties suited to specific scar types. For instance, fractional lasers target deep layers of skin to encourage new collagen growth, helping to flatten and smooth raised scars over time. Vascular lasers, on the other hand, are particularly useful for red or dark scars as they reduce blood vessels in the area, lightening the scar’s appearance. Laser therapy is typically performed in a series of sessions, each gradually reducing the scar’s visibility and texture. With Dr Lim’s guidance, a treatment plan can be created based on the scar’s characteristics and your skin type for optimal results.

Microneedling

Microneedling is already known for its ability to encourage collagen production, which can improve both the texture and elasticity of scar tissue. When combined with radiofrequency, the treatment penetrates even deeper into the skin layers, delivering controlled heat to further stimulate collagen and elastin. This combined approach can improve both raised and indented scars, blending them more seamlessly with surrounding skin. Microneedling with radiofrequency is performed over several sessions, and results improve gradually, providing a natural-looking enhancement without the need for invasive surgery. Dr Lim may recommend this for patients who seek a gentle but effective option to smooth uneven scars.

Chemical Peels for Surface Texture

Chemical peels use various acid solutions to exfoliate and remove the outermost layer of the skin, helping to smooth the surface of scars. Lighter peels can address pigmentation and minor surface irregularities, while deeper peels can penetrate further to treat thicker scars. By encouraging the growth of fresh, new skin cells, chemical peels can help scars look more even and improve skin tone. The type and strength of the peel can be tailored based on the scar’s depth, location, and your skin’s sensitivity to ensure a safe and effective outcome.

Cortisone Injections for Raised Scars

For thicker, raised scars, particularly keloids or hypertrophic scars, cortisone injections are a reliable option. Cortisone works by softening the scar tissue and reducing inflammation, which can help flatten and shrink the scar over time. A typical treatment involves a series of injections spaced out over a few months, allowing the scar to gradually improve in both appearance and texture. This treatment is especially beneficial for those prone to keloid scarring, and Dr Lim can assess whether it’s a suitable approach based on the scar’s response to previous treatments.

Surgical Scar Revision

In some cases, surgical revision may be recommended to improve a scar’s size, shape, or location. This process involves carefully excising the scar and re-closing the skin with advanced stitching techniques, aiming to create a finer, less noticeable line. Surgical scar revision is often chosen for scars that are too large or irregular to respond fully to non-surgical options. While it does involve a small recovery period, the improvement can be significant, especially when combined with other therapies like laser treatment or silicone sheets to support healing. Dr Lim’s experience in plastic surgery allows him to assess when revision might be the most effective route for achieving a balanced, discreet scar.

Fat Grafting for Depressed Scars

For scars that sit below the skin’s surface, like atrophic or depressed scars, fat grafting (or fat transfer) can help restore volume to the area. This involves taking a small amount of fat from another part of the body, purifying it, and injecting it into the scar. Fat grafting not only improves the skin’s contour but also stimulates collagen, giving a long-term improvement in texture and fullness. Fat grafting can be a good choice for those who have lost volume around the scar area and want a more natural, fuller appearance. Dr Lim will assess whether this option aligns with your goals, as it’s a specialised treatment best suited to particular types of scars.

These advanced options, particularly when guided by Dr Lim’s experience, give you a range of possibilities for scar improvement. Each approach is tailored, balancing safety with the most effective outcome for your skin type and scar characteristics.

Minimising Scar Appearance through Lifestyle Choices

Your body’s overall health has an impact on how well your skin heals, so here are a few lifestyle adjustments that can support your scar care:

Nutritious Foods for Skin Health: Vitamins and minerals are important for skin repair. Foods rich in vitamin C, like oranges and peppers, can aid collagen production. Zinc-rich foods like nuts and seeds support tissue repair, and proteins help provide the building blocks your skin needs to rebuild.
Staying Hydrated: Keeping up with water intake helps your skin stay hydrated from within, promoting a more balanced appearance. Dry skin can exaggerate scar texture, so regular hydration supports smoother skin.
Avoiding Smoking and Alcohol: Smoking and excessive drinking can slow healing, as they reduce blood flow and collagen production. Quitting these habits helps your skin repair itself more effectively.

FAQs about Surgical Scars

Can surgical scars completely disappear over time?

No, scars don’t fully disappear, as they are a natural part of the skin’s healing process. However, they can fade and become less noticeable. With the right combination of scar care, lifestyle adjustments, and advanced treatments, you can reduce a scar’s appearance, making it blend more naturally with the surrounding skin.

How soon after surgery should I start scar care treatments?

Scar care typically begins after the wound has closed and any stitches have been removed. Dr Lim will guide you on when to start, but generally, gentle treatments like silicone sheets, sun protection, and light massage can start within a few weeks. More advanced options like laser therapy or microneedling are usually recommended a few months post-surgery, allowing the scar time to settle.

Are there specific foods or supplements that can aid in scar healing?

Yes, certain nutrients support healthy skin and collagen production, which can improve scar appearance. Protein, vitamin C, and zinc are essential for skin repair, so including foods like lean meats, citrus fruits, and nuts can help. Omega-3 fatty acids found in fish or flaxseed may also support skin health. If you’re interested in supplements, consult your surgeon to ensure they complement your healing process.

Can different skin types affect how a scar heals and appears?

Yes, skin type plays a role in scar formation and healing. For example, darker skin tones may be more prone to hyperpigmentation or keloid scarring, while lighter skin types may have a higher risk of redness in the scar area. Tailoring your scar care routine to your skin type and getting advice from your surgeon can help manage these tendencies for a more even result.

Is it possible to prevent a scar from forming after surgery?

You can’t prevent a scar, but you can minimise its appearance from the start by following good wound care practices. Keeping the area clean, using proper bandages, and avoiding sun exposure all support better healing and can lead to a smoother, less visible scar. Starting scar-specific care at the right time also plays a role in minimising how noticeable the scar becomes.

Surgical Scars – Care and Minimisation Techniques