Operations and injuries that cause scarring

Alarplasty

When alaraplasty (plastic surgery to correct defects in or reduce the width of the nostrils) is performed the incisions are placed in the crease where the nostril wall meets the cheek. Alarplasty scars tend to stay slightly red/pink for the first month or two depending upon skin type and coloration.

Burn

A non-superficial burn (e.g. the deep partial thickness and full thickness burns) will always result in a burn scar. The scar’s severity will depend on the wound’s thickness as well as other factors, such as site of the scar, its healing process, age, sex, race of the patient, etc.

Burn scars may lead to different types of abnormal scarring.

  • Keloid scars are an overgrowth of scar tissue with the scar growing beyond the site of the injury. These scars are generally red or pink and will become dark over time.
  • Hypertrophic scars are red, thick and raised, however they differ from keloid scars in that they do not develop beyond the site of the injury or incision.
  • A contracture scar is a permanent tightening of the skin that may affect the underlying muscles and tendons, limit mobility and possibly lead to damage or degeneration of the nerves.

To prevent abnormal scar tissue, International Clinical Recommendations on Scar Management recommend treatment of widespread burn scars with a first-line therapy of silicone gel and pressure garments.

Cesarean section (C-section)

In a cesarean birth (C-section), the baby is delivered through an incision in the mother's abdomen and uterus (womb). The size of the C-section scar will depend on several factors: size and position of the baby, whether the C-section was planned or not, etc. Generally, the C-section scar is around 10–15 cm (4–6 inches) long and 0.3 cm (1/8 inch) wide.

Usually the “bikini cut” incision is used but sometimes the “classical” incision will be made vertically from just below the belly button (naval) to just above the pubic bone. To close the wound, some surgeons prefer to use staples whereas others still use sutures; there is little statistical evidence to show that one way or another will increase or decrease the size or the appearance of the scar.

Initially, the C-section scar will be red, raised and could itch. After the wound is closed you should start using Strataderm to make the scar softer, flatter and smoother and to relieve itching. The majority of women will develop “mature” C-section scars by the sixth month after delivery. If you have darker skin and/or are prone to keloids you should consult a physician before the C-Section.

Breast augmentation

The scar will usually depend on the type of incision used:

Inframammary incision, placed in the proximity of the crease where the breast and chest come together, is probably the most common breast augmentation incision used today. The incision is located to secure proper placement of the implant, but also to reduce the scar visibility. Scarring from properly located inframammary incisions should be easily hidden under a swimsuit top.

A periareolar incision (nipple incision) is placed along the outline of the areola, or the brown or pink pigmented region surrounding the nipple. The goal of the incision is to place it in the transition area between the dark areola and surrounding breast skin where it can be hidden. One advantage of the procedure is that there may be no visible scar, because of the color and texture characteristics of the areola border. In some cases, a scar may be visible.

Transaxillary incisions utilize one of the breast implants incision sites that involve no cutting of the breasts. Instead, the transaxillary breast augmentation incision allows breast implants to be inserted through the armpit. There is no scar on the breast and the armpit scar is not visible.

Rhinoplasty

Nasal surgery can change your nose by reshaping the underlying cartilage and bone. Most of the incisions are made internally and scars will not be visible. If you have an open procedure, you will have a small scar on the base of your nose, between the nostrils. Complications are rare.

Eyelid surgery (blepharoplasty)

Most upper eyelid scars heal very well. Sometimes, if more skin is removed, there can be a noticeable transition between thicker skin of the upper part of the lid and the thinner skin of the lower part of the lid.

Dog bite

Dog bites can be complicated with deep punctures and some tissue shredding dependent upon the type of dog. Minor cuts generally only require a thorough cleaning and bandaging of the wound. However, if infection is suspected, it is important to immediately contact a doctor who can provide the dog bite treatment needed. Signs of infection may include redness, swelling, red streaking, and fever. Seeking proper dog bite treatment is crucial to patient recovery. Other reasons to seek medical care include: a gaping wound, a wound that does not stop bleeding and open wounds on the face. Some of these are best treated with scar revision plus or minus tissue expansion.