Result of any surgical procedure is scarring. Each and every time the skin is cut either by scalpel or laser a surgical scar is produced. The quality and appearance of scars vary widely with the individual's healing process, the position of the scar on the body, and the degree of tension placed on the scar. The types of scars can be influenced by personal, familial and racial factors and cannot be controlled by the surgeon.
It is the plastic surgeon's ambition to try to hide scars as far as possible or to camouflage their existence. With some operations the scar will always be visible. With some areas on the body there is an unpredictable healing response of the scar. Some patients form hard, red, thick hypertrophic scars which cannot be anticipated by the surgeon before the operation. The type of scarring which has been produced by previous surgery MAY give an indication to the type of scarring that might result.
Some forms of surgery will predictably produce good scars such as the scar in front of the ear when face-lift surgery is performed. Other operations such as breast reduction or abdominal surgery produce scars which are frequently prone to stretching, thickening, redness and tenderness. In the worst cases, these scars will take one to two years to reduce in thickness and will never end up as thin line scars. The degree of stretching depends on personal healing qualities and the area on the body where the incision is located.
Scars will nearly always mature and flatten, but the time interval for this to occur is variable, from several months to several years. In the worst instance a keloid scar may develop which will remain raised, red, thick, tender and itchy, and despite various treatments might recur.
Surgical scars, when settled or mature, are always white (they contain no pigment producing cells) but occasionally with more superficial skin injury such as dermabrasion or chemical peel the scar can over pigment. This is usually due to sun exposure but can exacerbated with certain skin types, oral contraceptive pill (and other hormone treatment) and certain drugs. It is always important in the early stages to protect the scar from sun exposure.
Scarring also occurs in the deeper layers of skin, fat and muscle. This is more prominent when the skin or other layers have been separated and these scars can behave in the same manner as skin scars, becoming thick, lumpy, raised and tender. As with skin scars, this type of scarring will settle or mature with time but the process may take many months. The most noticeable areas where this deeper type of scarring can occur is in the cheeks of the face-lifts or after liposuction. Massage and other types of treatment can help and flattening the scar, but time is always necessary.
Scars are Always Visible, they Always Take time to Mature and the Degree and Quality of a Scar can Never be Guaranteed.