In plastic surgery, scars are the most common condition for outpatient consultations. Every day, I receive a large number of beauty seekers troubled by scars, and looking at their eyes and unrealistic expectations, I increasingly want to write a popular science article about scars. No chicken soup, no blood, Dr. Fu tells you several truths about scars.
Scars are one of the natural enemies of beauty. Whether it is a knife cut, surgery or a serious burn, all of them will leave scars of different degrees. As far as the current medical technology is concerned, scars can only be lightened and cannot be eliminated.
1.What exactly is a scar?
To recognize scars, we must first recognize the skin.
This seemingly simple structure can at least be divided into the stratum corneum, epidermis, dermis and subcutaneous tissue.
When the damage only destroys the epidermis or superficial dermis, the wound will heal quickly; when the damage reaches the deep dermis and even deeper, the damaged area needs to be filled by producing granulation tissues – these granulation tissues will eventually turn into ugly scars.
Scars are the inevitable result of post-trauma repair. Any surgery is an injury, so scars can never be removed surgically. Surgery can only lighten or shrink scars or change the shape of scars.
2.What are the types of scars?
Medically, scars are classified into three types.
Ordinary scars.
They are generally slightly lighter in color than normal skin, softer in texture, and some will appear wrinkled or depressed.
Hyperplastic scars.
Visibly red, prominent, and soft in texture, most patients will also feel pain and itching, and the vast majority will require aggressive treatment.
Scars.
Visibly prominent, often spherical, reddish in color or similar to normal skin, very pliable in texture, may be accompanied by significant pain, itching, and most stubborn.
3.The 18 weapons to deal with scars
Anti-scar medication.
Very effective for unstable scars and hyperplastic scars, and minimal damage to the patient, but hardly any effect on old scars.
Anti-scar patches and compression therapy.
More effective on significantly raised hyperplastic scars. Combined with a custom-made elastic sleeve to apply pressure to the scar, it can effectively limit the development of hyperplastic scars and sufficiently soften the scar to create the conditions for later surgical treatment.
Scar injections.
Scar creams and patches are not very effective, so scar injections are needed. However, this approach is more suitable for scars with small areas and the process of injections is more painful.
Surgical excision.
Old scars that do not look good can be removed and cosmetically re-stitched. The doctor can intervene during the formation of new scars by various means to make them as inconspicuous as possible.
Combined surgical-local injection therapy.
When hyperplastic scars and scars are too large, the scar edges need to be preserved, partially excised and then injected with scar injections.
Surgical reshaping or implants.
Either type of scar can develop contractures that can restrict joint movements or even distort the five senses. This is when surgery is needed to reposition the scar in a reasonable manner. Sometimes there is a price to pay for a slightly longer scar length, but the repositioning will improve the overall aesthetics.
Fat injection.
Initially some surgeons took autologous fat fillers to fill depressed scars, only to unexpectedly find that the quality of the scars improved.
Full face preconstruction and reconstruction.
A human face is reconstructed from the patient’s anterior chest skin and transplanted to a severely disfigured face through expander technology, stem cell technology and free blood vessels, and flap grafting technology. This is the first technology in China and is called “Chinese style face replacement”.
4.How can I reduce the impact of scars?
From the moment of injury, the body’s repair mechanism is already activated. At this time, accelerating the healing of the trauma itself can limit the scarring. The following points, to which you can receive good results with a little attention, are
Thorough cleaning of wounds and suturing.
Clean, infection-free wounds heal faster, and without inflammatory stimuli, scars generally do not grow like crazy. If it is an abrasion, do not pick off the scab after fully rinsing the wound, it is better to let it “ripen”, as constant stimulation of the wound will make the scar very obvious.
Avoid spicy smoke and alcohol.
Although there is no strong clinical evidence yet, long-term observation still reveals that eating spicy food, smoking and drinking alcohol will promote scar growth. However, the folklore that consuming soy sauce will deepen the color of scars is pure nonsense.
Reduction of activities.
Very often, trauma occurs in the joint area. Frequent movement of the skin around the joints can significantly stimulate scar growth, so it is best to reduce the activity. So the question arises, someone may ask what should I do if I have an injury around my mouth? The answer is to talk less and eat smaller bites.
Early application of silicone preparations.
The wound can be touched with water 24 hours after the stitches are removed. Be careful to keep the scar clean and scrub it gently. Applying silicone gel can accelerate the maturation of scars and avoid scar proliferation.
Paying attention to the above can even avoid some scar revision surgeries, and even if surgery is still required, it can greatly reduce the difficulty, trauma and improve the post-operative results. On the way to fight the disease, please don’t let your doctor fight alone, always trust your doctor and cooperate with him.
5.Which kind of scars should be treated by surgery as early as possible?
Often people just have wound stitches and rush to plastic surgery for surgery consultation the next day.
Once the wound is stitched up, it is not advisable to operate again within three months. If you rashly operate again, it is equal to aggravate the inflammatory response of the local tissues, which is just like pushing the scar.
At this time you need to be patient and wait for the scar to stabilize, actively cooperate with the doctor’s treatment, take medication on time, avoid mouth and reduce activities. However, there are some cases that need to be treated surgically as soon as possible even if the scar is still very red and swollen. For example, some hyperplastic scars and scars that affect the position of the five senses or cause joint stiffness because of contracture need to be operated immediately, otherwise they will lead to joint stiffness or crookedness of the five senses, which cannot be recovered even if the scars are softened.
Humans still know very little about many diseases, and scarring is one of them. But the completion of the Human Genome Project has taken the first step in a long journey to accelerate the search for the mysteries of life. It is believed that the mystery of scars will also be unveiled in the near future.