How To Scar Well

A scar is formed when our body tries to bridge a wound.  It is the proof of the body’s gift to heal. However, this repair work cannot restore the skin back to its original appearance.  Instead of an organised lattice, the collagen that forms in a scar is laid in a haphazard manner, leading to a scarred appearance.  Scars do improve in appearance over time, a process called “scar remodelling”.  It usually takes 1-2 years but can take up to 3-5 years for thickened “hypertrophic” scars.  Looks aside, some scars may even cause itch, pain or movement restriction.

Despite current day medical advances, even the best plastic surgeon will not promise that a scar, once formed, will go away over time.  “Scarring after surgery is one of the commonest concerns for women and men seeking cosmetic surgery,” says Dr Chia Hui Ling, Consultant Plastic Surgeon at SW1 Plastic Surgery Clinic.  So, how does one avoid or treat scarring if they are planning on having surgery?


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Calm The Wound

A quick recovery leads to less scarring.  Be it from trauma, acne, surgery or burns, getting the wound healed is your best chance at reducing scarring. Photomodulation using Light Emitting Diodes, or LED, is a new therapy that Dr Michelle Lim, Aesthetic Consultant from SW1 Clinic, starts her patients on after surgery and lasers that she expects to see a lot of swelling and redness. These special lights interact with cells to activate new collagen formation and enhance wound healing.“Patients that go through a course of LED Red therapy after laser or surgery has a swifter course of recovery,” explains Dr Lim. Dr Lim also recommends a multi-modal scar program, like the Scar Prevention Program at SW1 Clinic, which combines LED Red with Fraxel and VBeam lasers.

LED Red Light Therapy helps with healing, redness and swelling after surgery
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Optimize Scar Remodelling


Another way to curb scarring is to add anti-scar measures during the remodelling stage. The simplest way is start applying a silicone scar gel early to suppress the scar activity. Other ways to control scar reactivity, which leads to more scarring, is the use of steroid injections or lasers.

There are 2 ways laser can improve scars. The first way is to dampen scar activity by eradicating the blood vessels in red, active scars using PDL, or Vbeam Perfecta, laser.  The second way is to use a fractionated laser, like SmartX, Pico Smooth or Fraxel Dual lasers, to remodel the scar’s collagen network. The effects of these 2 modalities are synergistic.  It is research-proven that combining different modalities of scar treatment, like the Scar Intervention Program, gives a more superior result than 1 treatment alone.

PDL, vbeam, smartxide
Scar therapy after surgery helps improve scar remodelling and appearance
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Scar Revision

For some scars that do not respond to any treatment, another way to treat it is another surgery. The plastic surgeon will surgically remove the scar and close the wound again, using specialised techniques to reducing scaring. These surgeries are known as scar revision surgeries, and they are commonly followed by the scar therapies after surgery to maximise scar control.

scar revision
Revision surgery for a puckered forehead scar
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Opt For “Scarless” Surgery

Prevention is better than cure. Some cosmetic concerns can be addressed through “scarless” surgery.  These options are especially relevant for those known to have scarring tendencies like keloid scars.  In fact, these surgeries do leave scars, but they are often expertly concealed by plastic surgeons in orifices, such as the mouth, nose and eyes. For instance, in the face, chubby cheeks can be treated by buccal fat removal, which is done through a cut in the mouth, leaving no external scars.  Eye bags can lightened in a transconjunctival blepharoplasty, which means fat is extracted though an incision hidden behind the lower eyelid. Even when there is an external scar, an experienced plastic surgeonwill camouflage to minimise noticeability, such as placing it along the ear crease in a facelift, or along the double eyelid fold in an upper blepharoplasty.

Scarless transconjunctival eyebag surgery
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