It happens all the time.. I talk to patients about their surgery, including their scars, I tell them the scars will always be there. And then they ask me: "But I thought I was having plastic surgery?"
Any time you cut through the skin full thickness, you will get a scar as a result. Scarring is your body's way of healing and closing a wound. Scars happen, and nothing can prevent them from happening. BUT, the degree to which they are visible varies widely. Not seeing a scar doesn't mean that there is no scar there. That being said, while scarless surgery does not exist, invisible scars can be a reality.
1. The main factor in scar formation is genetics. If you are someone who scars a lot, then that will often be your fate. If you "heal well," you are already ahead of the game.
2. The second key to good healing is a proper surgical repair using all of the plastic surgery principles of optimal wound healing. This is operator dependent.
3. Optimize nutrition. You scar what you eat. If you have the right stuff going in, you are more likely to do the right things on the outside.
4. Follow instructions. Most patients underestimate how much their instructions can impact how their scars will look in the long run. If you are told to put on cream, use it. If you are recommended to massage, do it. All of these things have an impact; and even if each is a small factor in and of itself, the combined effect and longevity of use can create huge differences.
5. Keep it clean. There are situations in which wetting a wound is a bad idea. But unless you have been told to keep it dry, washing is a good idea. Infection, even on a small scale, can cause a lot of inflammation. Inflammation is the enemy of a good scar.
6. Keep it dry. When it's not being washed, a wound wants to be dry. Excessive wetness, including things like using too much ointment, can create goopy messiness. None of this will help the layers form or the bugs stay away.
7. Avoid the sun.
8. Avoid the sun!
9. Get ahead of problems early. If you think you have a thickening scar like a keloid, or if your scar is itching or burning, go see your surgeon. There are many problems that require early intervention for good treatment, and many interventions that often have success. Get in early for best results.
10. No lotions or potions. As you watch your scar mature and agonize over every change, people around you will have many suggestions for what to put on it. Some will seem reasonable, and others more like strange brews. Bottom line is that if it wasn't recommended by your doctor, it's likely to muck up the pot. Keep it simple.
Scars are unavoidable. Good scars are the goal.