One of the biggest downsides to having cosmetic surgery is the problem of scarring. Although some scars will disappear over a period of a year to 18 months, around a third of scars tend to be permanent and this can mean being left with unsightly marks or a hard raised ridge of tissue as a reminder of your plastic surgery.
The impact of scars can be very distressing, particularly if they are on visible parts of the body such as the face, neck, legs or arms. Recent surveys have shown that many people who have had surgery – both cosmetic and routine – were unhappy with the scarring left behind.
However prominent scars could soon be a thing of the past with the advent of several new approaches to minimising scarring.
Scarring is caused when both the top layer of the skin (epidermis) and the lower layer (dermis) are penetrated. However the amount of scarring that happens will depend on how well the skin responds to the issue and how well it copes with healing. The major factor here is collagen, a fibre-like protein which is a sort of glue to help the edges of the wound knit together. When the skin heals well, the edges of the wound are ‘glued’ together by the collagen in the skin helping the skin remain flat and making the scarred area as small as possible.
However, cells called fibroblasts, which are responsible for actually repairing the puncture, can go overboard and setup a new system of blood vessels to the scar area. This then causes too much collagen and this results in rigid lines and lumps and bumps around the wound. The collagen will sometimes ‘overflow’ leaving a rubbery scar over healthy skin tissue.
It is not fully understood why some cuts will heal better than others although good surgical practice, good genes and the location of the wound will all make a different to the way you heal.
So what can be done to help reduce scars?
Juvista is currently in the final phases of development and looks set to be one of the first scar prevention drugs on the market. Juvista is made from a naturally occuring human protein known as the transforming growth factor. Juvista is injected into the edges of the wound after surgery and this technique has so far shown to help reduce the risk of scarring. The injection works by helping the skin heal by weaving the edges together. It is anticipated that this drug will hit the market in the next three years.
Avotermin is another potential scar-reduction drug. Avotermin is made with a synthetic cell-signalling agent. Trials have already been carried out and the results have shown that using the scar prevention drug reduces the chances of scars becoming raised lesions or settling above the skin. This scar reducing drug also reduces the density and thickness of the skin that causes the scarring, helping reduce the appearance of the scar.
If you are going under the knife sometime soon, these developments are too far in the future. After surgery, try and keep your scars moist as this will help prevent scabs from forming. Scabs create a barrier to healing. By keeping the wound moist, you are keeping the collagen away from the surface of the skin and therefore helping to stop collagen overflow. Your cosmetic surgeon is likely to give you a dressing to help keep the wounds moist. Once this dressing has been removed, keep the wound moist by using a moisturising lotion around the scar. Moisturised skin helps wound-healing and ensures the collagen balance is kept even.
There is no need to use expensive creams or lotions either – products such as E45, baby oil, bio-oil or Nivea are all excellent moisturisers although do check you are not allergic to them before your surgery.
It is also worth gently massaging the scar for around a minute several time a day as this will help break the scar up. By massaging the area in a circular motion, you will help make sure the fluid in the skin is moved around and help stop the collagen from becoming lumpy and therefore help to prevent lumpy scarring.
If your scars are particularly prominent or raised, there are several options. Newish scars (scars that have formed within the last 18 months) can be treated with lasers, similar to the way that birthmarks are treated. The lasers target blood vessels that feed the scars, lessening the appearance of the scar. Several treatments are often required and each treatment is likely to cost around $200.
Older scars can be removed by further surgery however there is no guarantee that the resulting scars from the surgery will be any better than your current scars. For UK patients, large, old scars may be removed for free by the NHS, otherwise you will have to seek treatment from a private cosmetic surgeon.