Scars that experience complications like infection, increased tension or delayed healing can leave an undesirable appearance when it finally heals. Sometimes these undesirable scars are referred to as hypertrophic scars. Hypertrophic scars are raised, red/pink scars that do not extend beyond the original surgical incision. Any scars on the chest area will always be at high risk for hypertrophic scars. Patients at high risk for these scars can experience a recurrence after scar revision surgery. Therefore diligent aftercare is crucial to proper healing for patients who are at higher risk.
The decision to have plastic surgery is extremely personal, and you’ll have to decide if the benefits of the surgery outweigh the risks and potential complications of surgery.
You will be asked to sign consent forms to ensure that you fully understand the procedure and any risks. It is important that you address all your questions directly with your surgeon.
Scar revision surgery is normally done under local anesthetic. Typically, dissolvable stitches will be used on the surgical incision. But depending on the location and size of the scar, your surgeon may have needed to use non-dissolvable sutures.
Following local anesthesia, it may take 4-5 hours for the numbing effects to wear off – similar to something you would have done at the dentist. You can even eat and drink like normal before your procedure. We just ask that you not consume alcohol 24 hour prior to surgery. You must be accompanied by a responsible adult on your way home, who may either drive you home or take a taxi with you. You may feel pain slowly increase as the numbing wears off. Please ensure you have some acetaminophen or ibuprofen at home to use for any discomfort.
Remove all surgical dressings 48 hours after surgery. If dissolvable sutures are used, leave only the pink paper tape over the surgical incisions. It can take up to four weeks for the sutures to fully dissolve underneath the pink tape. At this time you can shower, but do not directly apply water pressure over any of the pink tape, only let the water run over it and pat gently to dry. The pink tape is waterproof and will start to peel off over the next 4 weeks, please cut off the portions that are no longer adhering to prevent the rest of the tape from falling off.
If non-dissolvable sutures are used, there will be no pink tape and you will need to book an appointment with the clinic 7-14 days after surgery for suture removal. Please apply polysporin twice a day, once in the morning and once at night. Make sure you wash off the previous layer of polysporin before reapplying a new layer. You are able to shower as normal, you are able to use soap and water on the incisions.
Please do not bathe or soak your incisions until all incisions have completely healed. Swelling and bruising is common following surgery and is to be expected. The swelling and bruising should subside within 2-4 weeks after surgery. You will be provided with a silicone ointment after your surgical incision has healed to improve the appearance of the scar.
Patients are able to get up and walk around right after surgery. Most patients are back to normal daily activities the next day. However, there should be no heavy lifting for 4 weeks following surgery to ensure there is no separation of the surgical incisions. Most patients who have sedentary jobs do not take time off work. If your job involves a lot of physical activity be sure to speak with your surgeon during your consultation with regards to how much time off you will need for your specific daily tasks. Most patients are comfortable driving the next day. However, it is not uncommon for a spot along your surgical incisions to open up during the postoperative stages due to increased tension on the incisions with movement or poor healing. This is not a serious complication, and can be remedied with daily dressings, but it does mean a delay in your expected recovery time.
If you have any questions or concerns, feel free to give us a call at (403) 800-9157 and leave a message as necessary. If you are unable to reach us, and need medical advice please call 811 to speak to a nurse, the line is free of charge and available 24 hours a day. If it is a medical emergency please call 911 or go to your nearest hospital, or call the Peter Lougheed Centre Switchboard at (403) 943-4555 and ask to speak to the plastic surgeon on-call.
Hypertrophic scars are raised, red/pink scars that do not extend beyond the original surgical incision. Hypertrophic scars occur when myofibroblasts, a type of healing cell in the body, produce too much collagen during the healing phase. People who produce more of the type of melanin that is responsible for darker pigments are at higher risk for developing hypertrophic scars (melanin is the pigment that gives human skin their colour). Overproduction of collagen can also occur when your surgical incision becomes infected or inflamed because of excessive tension or motion. Any scars on the chest area will always be at high risk for hypertrophic scars. Diligent aftercare is crucial to proper healing for patients who are at higher risk.
A good candidate for surgery is a patient who is relatively healthy and has realistic expectations for post-operative outcomes. It is also strongly advised that you be a non-smoker at the time of surgery. If you are a smoker we recommend you quit smoking at least 3 months prior to surgery as nicotine can interfere with blood supply and potentially cause complications with healing after surgery.