Every surgery leaves scars, but the goal with any type of aesthetic surgery is to minimize the appearance of scars as much as possible. The best way to minimize scarring is to avoid creating an unsightly scar to begin with. Meticulous technique is essential, as it will provide the best chance of a scar to heal well. Paramount to a successful closure is avoiding tension along the incision line, perfect approximation and careful eversion of skin edges. Skin edges tend to pull apart as wounds heal and contract and if there is any tension on the wound a wide, unsightly scar results.
Proper technique is always important but most critical when an incision cannot be hidden and is in a highly visible place, such as with a male facelift patient who has experienced hair loss. There are also instances where we can hide scars. For example, with a chin implant, the implant is typically placed through an incision through a natural skin wrinkle or skin crease located beneath the chin. That way the resultant scar “hides” within this crease. Hiding certain facelift scars is possible as well, as some incisions can be placed along the hairline and behind the ears.
Aside from good surgical technique to minimize the appearance of scars, proper wound care is important as scars mature. Keeping the incision area clean while healing is important as well, along with avoiding any strenuous exercise that may create tension in the incision area. Sun protection with sunscreen of SPF 30 or higher is vital, as sun exposure will result in hyperpigmentation (darkening of the scar). Close follow-up is important because even if you care for a wound perfectly, a scar may still form. Scar formation can be modulated during the healing period using injections of a dilute steroid and 5-fluourouracil, as well as with laser treatments (pulsed-dye laser, fractional resurfacing laser).
Overall, there are many measures that can be taken both during and after surgery to minimize the appearance of scarring and leave the patient with a fantastic result.
