Scars are fibrous tissues that replace normal skin following an incision or wound. They can be an unpleasant aftereffect of a cosmetic surgical procedure. Prominent scars can also affect self-esteem and diminish the positive results of cosmetic surgery.

Some people scar more than others. The way your skin heals and the type of scars you develop after cosmetic surgery depends on many factors, including:

• The depth and size of the incisions.
• The location of incisions.
• The skill of your surgeon.
• The post-surgical care you receive.
• How well you follow post-operative instructions.
• Your age.
• Your ethnicity.
• Your genes.

As you can see, some variables are within your control. The depth and size of incisions can be changed only to a certain degree depending on the procedure.

You do however have control over finding an experienced surgeon and following your post-operative instructions diligently. That way you can minimise the appearance of scars as much as possible.

Scars resulting from cosmetic surgery often disappear over time or fade away and become less visible. This is why most surgeons tell you to wait at least one year before having scar revision surgery or other invasive treatments. This period gives your body the time it needs to complete the healing process.

If, however, your scarring is very obvious, you have several options:

• Scar treatment gels and creams.
• Silicone gel sheeting.
• Collagen and steroid injections.
• Dermabrasion.
• Laser resurfacing and scar revision surgery, which usually involves skin grafts.

It is advisable to discuss options with your surgeon before using any of these treatments on your scars.

Creams and gels

Your surgeon will recommend that you use one of the many over-the-counter treatments available for treating scars. Scar creams usually contain silicone, onion extract, vitamins and skin moisturisers. Scar gels are usually silicone based. Silicone gels help to minimise the size and colour of scars.

The Scar Treatment Association in the USA rates the effectiveness of various scar treatment brands. Among the many creams and gels formulated to diminish surgical scars, it has given ‘Superior’ ratings to the brands; SCARPrin, Dermatix Ultra, Talsyn-Cl, Kelo-Cote and Zen-Med. These products are all available in Australia.

Collagen and steroid injections

Collagen or steroid injections may improve the appearance of damaged skin.

Collagen injections can increase the volume of scars, treating scars that have a depressed appearance. The effect achieved through this treatment, however, is temporary. You may need injections regularly to maintain the appearance of smooth skin.

Steroid injections, usually injected on the scar, minimising absorption into the blood stream, help soften or reduce hard scars. A course of injections may be needed over a four to six week period. Injections must be administered under medical supervision.

Silicone gel sheeting

Silicone gel sheeting can improve the appearance of protruding scars by softening and flattening them and by lightening the colour of reddened scars.

Waterproof, flexible silicone gel sheets are comfortable to wear. They can be self-applied after cutting them to fit the scar area. They adhere to even tricky areas such as your joints.

Dermabrasion

This is a treatment that helps reduce irregular surface of the skin. Dermabrasion, as its name indicates, involves abrasion of the skin. The treatment involves removing the upper layers of the skin; using an abrasive mechanical device. These devices use various types of crystals—such as diamond or alum oxide—for their abrasive surface.

Your physician will then use a specialised wand to remove the top layer of skin to reveal the less damaged, fresh skin underneath. This exposed skin layer can then heal with a more natural appearance.

Laser scar resurfacing

Laser resurfacing uses laser beams to remove the top layer of scarred or damaged skin. The layer of skin underneath is then exposed which heals smoother and tighter.

Laser scar resurfacing is an invasive cosmetic procedure. It has to be performed under local anaesthesia, usually by applying a numbing cream on the area being resurfaced. This procedure takes some time to show its effects, as the fresh skin exposed also needs time to heal.

Scar revision surgery

In surgically removing scars, the scar tissue is removed and healthy skin surrounding the original scar replaced. However, the scope for this is limited as skin can be stretched only so far. If the scar area is large (i.e. burn scars), or there is little surrounding skin, a skin graft may be needed.

A skin graft is a section of skin taken from another location, which is attached over the scarred area. It takes time for new blood vessels, nerves and soft tissue to form.

A method called Z-plasty is used to move scars from one area to another; this usually moves the scar into a natural skin fold, minimising its visibility. Z-plasty does not however completely remove scars.

Self-treating your scars

Ask for a recommendation or prescription from your surgeon as to the best scar treatment for your specific needs.

Many surgeons provide their patients with silicone gel sheeting, to continue the treatment after the surgery. Seek your surgeon’s guidance on how best you can use scar sheeting and other medications to diminish your scars.

Other techniques, such as dermabrasion are safest with specially trained professionals. Laser treatments and scar revision surgery should only be done under medical supervision.