Scar removal after surgery

After surgery, a scar remains on the body - an area of ​​connective tissue. Existing methods for getting rid of unsightly marks on the skin are varied. Therefore, the question of how to remove a scar after surgery should be preceded by a brief excursion into the typology of scars. The reasons for differences in the effectiveness of the same products are due to different characteristics of postoperative skin damage.

How are different types of scars treated?

Many methods of treating scars are available to specialists in medical and cosmetic clinics. To choose a method for removing scars after surgery, you first need information about the type of damage. It is necessary to diagnose the condition of the patient’s skin and the whole body.

How to remove scars on the stomach?

Minimally invasive surgery has almost eliminated the side effects of surgical interventions in the form of long and wide scars. With a gentle technique, almost no traces of punctures remain. If scars after laparoscopy are properly cared for from the very beginning, the cosmetic effect will be excellent. Much depends on where the punctures are made. Typically, during laparoscopy, the doctor makes 3-4 small holes (about 1 cm or less):

1. 1 - below the navel for introducing a mini-video camera into the abdominal cavity.
2. 2–4 - in the lower abdomen for introducing microsurgical instruments.

Caring for punctures after laparoscopy is carried out in two stages and includes measures aimed at preventing the formation of scars:

1. Applications with a substance that stimulates healing (Curiosin gel).
2. Lubrication with a drug that softens scar tissue (Kontraktubeks gel).

Video about keloid scars after surgery

Cicatrix cream from the Spanish company Catalysis (test results)

The most affordable remedies for scars after surgery - special creams and ointments - promote resorption and healing of scars. Such medications are varied, but their methods of use have much in common. Basically, it is necessary to apply the ointment to postoperative skin lesions 1–2 times a day and continue the course of treatment for at least 8–10 weeks.

Visible results from using the Cicatrix restorative cream from the Spanish company Catalysis appear after 3 weeks (on fresh scars). In 2007–2010, medical centers in Western Europe and Russia assessed the effectiveness of Cicatrix cream in a group of patients with fresh scars. Here are the results of the study published by the Testing Laboratory Center of the Central Clinical Hospital of the Russian Academy of Sciences.

The researchers explained the positive results of using Cicatrix cream by the synergistic effect of the interaction of the components:

1. Asiatic and madecassonic acids in the Asian centella extract stimulate the activity of fibroblasts and improve microcirculation.
2. Pine extract (Pinus sylvestris) has antioxidant properties far superior to vitamins E and C. Prevents collagen destruction.
3. A unique lipid complex of ceramides and low molecular weight hyaluronic acid retain moisture.

The restorative drug "Cicatrix" promotes proper wound healing by resorption and reducing the formation of scar tissue. The synthesis of collagen types I and III is activated, which compensates for the lack of the main building material of the skin. Cicatrix cream reduces chronic inflammation in damaged tissues and ensures normal epithelization.

Plastic surgery originated a very long time ago - the first mentions of it are contained in sources written at the dawn of our civilization. Several thousand years before our era, healers in different parts of the world, while laying the basics of medicine, formed the basis for plastic surgery.
Then they directed all their efforts not only to the restoration of body parts lost or damaged in battles, but also to achieving the most aesthetic postoperative result. But the last task turned out to be so difficult that several hundred generations of “surgeons” had to change before plastic surgery learned to cover up traces of any damage from the human body, without leaving “a single piece of evidence” behind. The desired goal - to remove any scars - was achieved relatively recently - at the end of the last century. Then surgeons learned to smooth out the effects of burns, injuries and various diseases through surgery. Moreover, even then “plastic surgery” could “cleanse” the skin even of hardened and keloid scars.

Modern plastic surgery for scar removal

Today, in addition to classical methods, plastic surgeons also “operate” with laser, injection and expander techniques, which are something between plastic surgery and cosmetology. At the same time, in terms of the effectiveness of scar removal, they are comparable to conservative techniques, but at the same time they are a more modern and minimally invasive solution to this problem. However, the choice of a particular method of scar removal depends on its type, location, etc.

What types of scars can plastic surgery remove?

In general, any scar or scar is the result of the process of replacing skin tissue at the site of damage with connective fibrous tissue. Only in some cases it can be a thin, barely noticeable pale strip, in others it can be a rough and large scar, which causes not only moral discomfort, but also physical discomfort, because in some cases it may involve excessive tension of the skin. Such scars are also called keloids.

In general, there are several types of scars that can be removed by plastic surgery:

1. small round scars or thin strips drawn in, which do not appear under the influence of external factors, but are the result of natural processes in the body. This includes stretch marks from pregnancy, acne scars, etc.;
2. -with a smooth surface - can be white or pale pink, they appear either as a result of surgical interventions, or against the background of the independent development of fibrous tissue after minor injuries;
3. keloids - they roughly rise above the surface of the skin, most often such scars have a dark burgundy color. In addition to external discomfort, they cause a person physical discomfort, because, firstly, due to the tension of the skin, which was necessary for suturing, he is constantly haunted by a feeling of tightness and itching. Quite often, such scars begin to grow over time;
4. hypertrophic ones are less problematic. Although they rise above the surface and differ in color, they do not cause physical discomfort to a person. Such scars appear against the background of excessive production of collagen, which, without having time to dissolve, accumulates in the damaged area, forming a relief surface.

Quite often, people turn to a surgeon only after recovering from surgery or an injury. In such situations, surgeons refuse plastic surgery to remove scars, since the minimum period for the formation of its final appearance is 4-12 months, depending on the type of initial damage, the genetic characteristics of the body, the hormonal state and the habits of the patient. Until the end of this period, it is impossible to “disturb” the tissue in the damaged area.

In general, a scar is formed in 4 stages:

1. the first week and a half after skin damage. During this period, granulation tissue forms, blood vessels increase in size, swelling decreases and redness disappears. Proper care is especially important here - to prevent the wound from becoming infected, and also to avoid physical activity, which can cause the sutures to separate. If this stage is completed successfully, the wound will heal with careful primary intention.
2. it continues for 20 days, starting from the 10th day after the injury. At this stage, the formation of the primary scar occurs. Its characteristic features are the formation of loose, easily stretchable tissue of a pink hue. This tissue is an external manifestation of the active production of collagen and elastin in the damaged area - fibers that are responsible for restoring the skin after damage.
3. the next two months. A scar with a dense structure forms at the site of damage. Gradually, blood circulation in this area slows down, as a result of which it begins to turn pale.
4. final formation, which lasts from 4 to 12 months.

As mentioned above, for plastic surgery to remove scars, a prerequisite is the formation of the scar. Firstly, because the final appearance of the scar can be quite aesthetic and satisfactory for the patient, even without the participation of plastic surgery. Secondly, until the end of formation, “fresh” tissues are prohibited from being “disturbed” by external influences, since this can negatively affect their further maturation.

Plastic surgery scar removal

It was said above that the choice of scar removal method is influenced by several factors, among which, in addition to the type, its localization is also important. So, for example, if the scar is located on the face, the surgeon will suggest a technique for cutting out the scar, followed by stitching the edges of the wound using an internal suture technique, located not on the surface of the skin, but inside - parallel to it, and using the thinnest threads, less than a human hair in diameter. If the scar is located on another part of the body, then it may be appropriate to carry out laser excision there, or resort to dermabrasion.

Besides, decisive factors here will also become:

1. the location of the scar relative to the natural tension of the skin;
2. its size (affects the nature of scarring, large-scale injuries are healed more “reliably” and less aesthetically pleasing than small and subtle injuries);
3. the age of the patient (in children and adolescents, wounds heal quite quickly, in people over 30, regeneration processes in the skin proceed much more slowly, and prolonged healing can negatively affect the results of plastic surgery for scar removal);
4. genetic predisposition to unaesthetic healing of wounds and injuries. For the surgeon, the condition of the scar can become a guideline for choosing a scar removal technique. If the patient is predisposed to the formation of rough scars, the surgeon is more likely to suggest resurfacing.

Plastic surgery for scar removal: modern methods

Surgical removal

This method is indicated when it is necessary to remove rough, old scars of various sizes obtained after operations, as a result of gunshot wounds, burns and other accidents.

The intervention is performed either under local anesthesia or general anesthesia. First, the surgeon cuts out the scar; he carries out this procedure in such a way that the edges of the wound can then be carefully compared. Next, he places a suture just below the surface of the skin and parallel to it, using the finest threads. To achieve the most aesthetic result, the stitches are removed already on the 3rd – 4th day.

Postoperative recovery here takes no more than 5 days. However, during this period and the next few weeks, the patient must strictly follow all the surgeon’s recommendations, which may also include undergoing a course of physical therapy or cosmetic procedures.

Laser technologies in plastic surgery for scar removal

Such methods will be effective if it is smooth in structure but has a bright color. There are no interventions, no damage to surrounding tissues, and no sutures are required.

Laser removal is carried out in several stages: first, under the influence of a laser beam, the production of fibroblasts - cells that synthesize collagen fibers - is accelerated. Externally, the first procedure results in the effect of some discoloration of the scar. Next, the “old” tissues are destroyed, which is manifested by their gradual smoothing and comparison in color and structure with the surface of healthy skin.

Expander dermotension

Suitable for removing extensive damage.

A relatively new technique in plastic surgery for scar removal, the essence of which is to create a completely new “invisible” scar in place of the previous one. To do this, the tissue in the scar area is first stretched - a sealed balloon or expander is implanted there, stretching the skin. After this, the surgeon excises excess skin where the scar is located, and then sews healthy tissue together with an “invisible” suture.

Dermatologic techniques

It assumes a mechanical effect on the damaged area in order to remove the upper layers of skin.

In this way, large-scale skin damage, such as burns, rough voluminous scars, etc., is removed.

Steroid injections

The essence of this technique is to slow down the processes of protein production, which provoke the growth of the scar. With a subsequent increase in the concentration of steroids, thinning and destruction of scar tissue also occurs.

Injections are preferably administered to smooth out relatively smooth scars.

Each surgical intervention entails a violation of the integrity of the skin. As a result, a seam is formed, which in some cases may have a pronounced cosmetic defect. That is why many patients are interested in the question of how to remove scars after surgery.

Stages of scar formation

Scar formation has several sequential stages, which include:

1. Scar healing stage. Healing of the suture after surgery can take up to 10 days. At this time, the wound is connected with the help of granulation tissue, and when force is applied, divergence of the fused elements may occur. Since fastening occurs by tension.
2. The stage of fibrillogenesis and the formation of a weak suture. It can last up to a month. As a result, the number of vessels decreases, as well as cellular elements disappear. There is an increase in the number of elastic and collagen fibers. The scar areas are connected and can be separated.
3. The stage at which a durable scar is formed. The duration of this stage can reach 3 months. During this period, a dense structure made of connective tissue grows. The number of vessels in the scar tissue decreases.
4. Transformation stage. Its duration can last a year. High-density scar tissue is created, in which there are no blood vessels. In tissue junctions, the cells are denser and difficult to separate. The patient needs to consult with a specialist to decide how to get rid of the scar after surgery.

Postoperative scar care

In order to prevent the formation of rough scars, it is necessary to follow procedures aimed at proper care from the first days after surgery. Among the basic rules are:

1. During the first week after the operation, daily dressing of the wound with treatment and application of a sterile napkin is required. In addition to a cotton gauze napkin, you can use a special plaster.
2. If there is no suppuration or wetting, postoperative scars are treated with a solution of brilliant green.
3. If the wound begins to turn red, an infiltration zone is identified, or it begins to get wet, the use of agents that have an anti-inflammatory effect is required. Among them, the most popular drug is Levomekol ointment.
4. After a week, when the suture material is removed and there are no signs of inflammation, there is no need to apply a bandage. It is necessary to contact a specialist about how and when to remove the sutures after surgery.
5. When preserving the suture material, it is forbidden to allow it to become wet, as well as to allow contamination of the skin of nearby tissues.
6. It is prohibited to use an alcohol solution to treat a postoperative suture. This can cause the exposed surface to burn and increase keloid formation.
7. In order to clean the surface of dried blood particles, as well as remnants of bandage or gauze. Removing them may cause bruising. That is why it is necessary to first apply a large amount of hydrogen peroxide, which helps soften the crusts. This will ensure their smooth removal from the surface of the wound.

Treatment of the suture after surgery should be carried out using sterile instruments and carefully treated hands.
It is forbidden to reuse dressing material, as this may cause infection.

Removal methods

After the interventions, many patients have a question about how to remove the scar after surgery. Currently, there are several different techniques that are widely used by patients. Treatment of scars after surgery includes the following techniques:

The procedure for removing scars is hardware-based. The procedure involves removing epithermal cells using a cutter. The procedure is one of the most effective, but it is also highly traumatic, since scar tissue is removed down to the papillary layer. During the procedure, the patient may experience severe pain, which requires pain relief.

Among the indications for the use of this type of scar tissue removal are pronounced keloid or hypertrophic scars after surgery, as well as retraction of scar tissue with an atrophic form of the scar. The procedure helps prevent excessive growth of connective tissue structures and helps restore skin texture. Healing of scars after surgery can take a long time.

Compared to other methods of removing such tissue, dermoabrasion is one of the most effective. But, you should remember, it also does not always give 100% results. Factors such as:

1. Fresh tripe. Earlier scars after surgery are more easily subjected to dermoabrasion.
2. Small areas of scar tissue.
3. Small depth of skin damage.

Removing scars after surgery using laser resurfacing is one of the most effective. Because, unlike many other methods, it allows you to remove various types of scar tissue. In addition, its implementation is absolutely painless, which does not cause discomfort to the patient. Laser resurfacing is carried out on various surfaces, including areas with soft and thin surrounding skin. The most popular method is used to excise the scar after mole removal. During the procedure, there is no dissection of the skin or excision of the scar area, which prevents the entry of an infectious agent with subsequent inflammation of the tissue.
During the procedure, a thin layer of cream with a moisturizing and mild anesthetic effect is first applied to the skin. Next, laser resurfacing is performed directly, which can last up to an hour. During the procedure, dead cells are removed. Areas with young cells remain unaffected; the laser does not reach the papillary layer, unlike dermabrasion. After the procedure, you need to apply an ointment with a healing effect based on panthenol to the treated area. It is acceptable for small crusts to appear during the first day, which dry out and fall off on their own. Laser resurfacing will continue for normotopic, hypertrophic, atrophic, and keloid scars.

Treatment of postoperative scars using cryodestruction is a not so popular procedure for removing scar tissue. Removal of postoperative scars and scars is based on the action of tissue through liquid nitrogen. It is carried out in a beauty salon, where a specialist applies liquid nitrogen to the skin of the scar. The procedure is absolutely painless and non-invasive, the risk of infection is minimal. After cryodestruction, bubbles may remain on the surface of the scar, which disappear on their own and the tissue is rejected. The fabric is not always rejected after the first application; if necessary, two to four sessions are required. Cryodestruction may not remove scars after surgery of large size or deep localization. Before and after its implementation, no care procedures are performed.

Hardware techniques and surgery

In some cases, scarring on the surface of the skin may require invasive removal techniques. This is especially necessary in cases where scars remain after severe operations on large areas of skin. In addition, surgical emphasis is performed after healing by secondary intention.
These procedures are performed by plastic surgeons. Among the main methods are:

1. Plastic surgery with local fabrics. To remove a scar, rough tissue is excised and healthy areas are stretched, which are stitched together using a cosmetic suture. A scar remains on the surface of the skin, but it will occupy a smaller area and severity.
2. Plastic surgery using expanders. A similar operation is performed if it is necessary to remove a large area of ​​scar changes. An expander is inserted under the skin, which helps stretch the skin. They help eliminate various processes, including such as getting rid of scars after surgery.
3. Plastic surgery through transplantation. After removing the scar, the upper layers of the skin are split layer-by-layer, which ensures a gradual increase in tissue. Removal of postoperative scars is performed under general anesthesia.

Medications

Among the drugs are:

1. Diprospan. A glucocorticoid drug is used for various types of scar tissue. Against the background of keloid changes occurring as a result of the reaction of the immune system, Diprospan promotes the development of an immunosuppressive effect. As a result of its use, the process of kelodide formation is inhibited and many cosmetic defects are eliminated, including such as removing scars after surgery. The product is used in injection form, the drug is injected into the scar area over several days. The best effect is achieved in the early stages of tissue growth after surgery. As treatment progresses, a change in color occurs with pallor and a decrease in size. Treatment of scars after surgery with Diprospan may not be effective for large lesions.
2. Contactubex. The drug, which has a combined composition, contains components that ensure the breakdown of rough connective tissue and prevent the inflammatory process with subsequent hypertrophy. The allantoin contained in the composition has a keratolytic effect, heparin breaks down microthrombi and promotes fibrinolysis. Bulb extract relieves inflammation. Treatment of postoperative scars is carried out in accordance with the instructions, according to which it is necessary to rub the gel two or three times a day. The duration of application depends on the severity of the process; for fresh scar tissue, application is carried out within a month, old or rough tissue requires treatment for several months. The maximum duration of application can be one year. It is not recommended to treat scars after mole removal with this product.
3. Kelofibrase. A combined ointment made on the basis of Heparin, urea and D-camphor leads to the resorption of scars after surgery. Urea is the main moisturizing component of the drug, which prevents skin tightening and the formation of elastic formation. The destruction of tight connections between cells also occurs. The product helps achieve several effects, including speeding up the healing of sutures after surgery.
   Heparin improves blood circulation, helping to sprout new blood vessels and ensure full trophism. Camphor reduces the inflammatory response and stimulates microcirculation processes. The ointment is applied several times a day until it is inscribed; massage of the area is allowed. The best therapeutic effect is achieved when used in the early stages.

Despite the presence of many methods that help hide a cosmetic defect, before removing a postoperative scar you must seek help from a specialist. He will decide the question of which is the most suitable method to choose.

Video: How to remove a scar