Scars and Healing
The short answer
Scars and Healing explains where surgical scars may sit and how they commonly change as tissues heal. It may suit patients weighing a contour change against the permanent scar required to create it. Dr. John Samas discusses candidacy, limits and recovery during a Northglenn consultation.
Scars are permanent. Where they sit and how long they are is the part that gets decided before surgery.
In short
What else should you know?
Every operation that cuts through skin leaves a permanent scar. Scars typically mature over roughly 12 to 24 months and generally become flatter and paler in that time.
The decision you make before surgery is not whether to have a scar. It is where it sits, how long it is, and what shape you get in exchange.
The trade-off
Length of scar against amount of skin removed
In any operation that removes loose skin, the incision length is what limits how much skin can come out, and how much skin comes out is what determines the shape. This is the central choice in arm lift and in breast lift.
It is why the shorter-scar versions exist and why they are not simply better. A mini arm lift has a much shorter scar and treats much less laxity, which the arm lift comparison sets out side by side.
Being shown where the scar will be, and how long, before you agree to an operation is not an optional courtesy. Ask to have it drawn or described precisely.
By procedure
Where the scars sit
General positions. Your own markings are made at the pre-operative visit.
- Breast augmentation: a short incision, most often in the crease beneath the breast, though the approach is discussed case by case.
- Breast lift: patterns vary with how much lift is needed, ranging from around the areola to an additional vertical line, and in some cases a line in the breast crease.
- Breast reduction: similar patterns to a lift, generally at the longer end because more tissue is removed.
- Abdominoplasty: a horizontal scar low across the abdomen, positioned to sit below clothing, plus a scar around the navel.
- Mini abdominoplasty: a shorter horizontal scar, with no scar around the navel.
- Arm lift: a scar along the inner or back of the upper arm, its length set by how much skin is removed.
- Liposuction: several very small access incisions rather than a long line.
- Minor excisions and earlobe repair: a fine line at the site of the removal or repair.
How healing works
The phases you will actually notice
In the first weeks the incision is closed but fragile, and the surrounding tissue is swollen. Tension across the wound during this period is the enemy, which is why lifting restrictions exist.
Over the following months the scar remodels. It commonly goes through a phase of looking worse before it looks better, becoming firmer, raised and pink or red. Patients who have not been warned about this find it alarming, and it is usually a normal part of the process.
Maturation continues for roughly 12 to 24 months, and the appearance at three months is not the final appearance. Judging your result, or your scar, early is the most common source of unnecessary worry.
What helps
Reasonable scar care
Nothing here erases a scar. These are the measures that give a scar its best chance.
- Follow the wound care instructions exactly, and start scar treatment only when Dr. Samas says the incision is ready.
- Protect the scar from the sun while it is immature.
- Avoid nicotine in every form. It reduces oxygen delivery to healing tissue and shows in the scar.
- Respect the activity restrictions. Tension across a healing incision widens the eventual scar.
- Support the area as instructed, including any garment you have been given.
- Raise thickening, itching or spreading with the office early rather than at the one-year visit.
FAQ
Scar questions
This page is general information. Candidacy, recovery and what to expect are discussed at your consultation.
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