Scar And Wound Management
As Plastic Surgeons, we often get asked about scar and wound management, that is how to make them go away. Unfortunately, when a wound or laceration is deep enough there will be a scar. So far, even with todays technology, only fetuses heal without a scar. There is no magic technique or scar removal cream available to make scars disappear. It is a frequent misconception that if a Plastic Surgeon operates on a patient, there will be NO scar. However, the Craniofacial Team of Texas surgeons are trained in Pediatric Plastic and Reconstructive Surgery where they are specialty trained to disguise and minimize scars so that they are hidden, but there will always be a scar if you look close enough.
How Long Will It Take To Heal From Mohs Surgery
The answer to this question is, of course, it depends. Dr. Sam Naficy, a Seattle facial plastic surgeon, talks about the recovery time from work following Mohs Surgery: “Recovery can take between several days to several weeks based on the size, complexity, and location of the defect.”
Doctor Kenneth G. Gross reports in “A Patient’s Guide to Mohs Surgery” that: “Complete healing of the surgical scar takes place over 12 to 18 months. Especially during the first few months, the site may feel swollen or lumpy and there may be some redness.”
The American College of Mohs Surgery states that: “Generally, a post-surgical scar improves with time and can take up to one year or more to fully mature.” In reviewing the literature it seems that complete healing from Mohs surgery can take a year or more and much depends upon the size and depth of your wound.
Why Are Some Scars More Noticeable Than Others
Our eyes notice contour irregularities and pigment differences easily. If a scar is too thick and raised or depressed, then our eyes get drawn to that area. Differences in color also make scars more noticeable. If a scar crosses natural wrinkle lines, then they become more noticeable with facial movement because the scar will not move like normal skin. An ideal scar is narrow and has even skin edges with the surrounding tissue, and is hidden in a natural skin crease.
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The Physical Benefits Of Scar Massage:
There are a number of factors that can affect wound healing, however scar massage can help speed up the healing process and provide the below physical benefits:2
Reduces the build-up of scar tissue the scar itself is a growth of new collagen fibers that the body forms to repair any damage caused by a wound. Excess tissue that forms can make a patients muscles feel weaker and stiff. Regular massage helps prevent the build-up of this excess tissue, leaving skin feeling suppler.2
Relieves itching when a wound forms, the nerve fibers close to the skin detect the difference and send signals to the spinal cord this can result in a feeling of itchiness.3 When massaging, the bodys soft tissue structures are manipulated4 and a number of studies have found that massage can help to reduce the itchiness.5 6
Stimulates blood flow massaging stimulates the flow of blood in the body and this in turn:
Improves flexibility, allowing the skin to feel less rigid
Helps reduce redness and swelling making the skin appear less aggravated and hence creating a flattened appearance
Helps decrease numbness and regain feeling in the area.2
Nicole Cutler Lac Mtcm Dipl Ac
Nicole Cutler, L.Ac., MTCM is a long time advocate of integrating perspectives on health. With a Bachelor’s degree in Neuroscience from the University of Rochester and a Master’s degree in Traditional Chinese Medicine from Five Branches Institute, Nicole has been a licensed acupuncturist since 2000. She has gathered acupuncture licenses in the states of California and New York, is a certified specialist with the National Acupuncture Detoxification Association, has earned diplomat status with the National Commission of Chinese and Oriental Medicine in Acupuncture and Chinese Herbology and is a member of the Society for Integrative Oncology. In addition to her acupuncture practice that focuses on stress and pain relief, digestion, immunity and oncology, Nicole contributes to the integration of healthcare by writing articles for professional massage therapists and people living with liver disease.
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How Soon Can I Exercise After Mohs Surgery
The longer it takes a wound to heal, the greater the chance of a noticeable scar, and resuming physical activity too soon could also slow the healing process. You dont want to overdo it because you can pop a suture or stretch the wound site, said Dr. Platzer. In addition, strenuous activity that increases your heart rate could cause the wound to bleed.
How long youll need to wait before returning to your exercise routine depends on the location of the incision. If its on the face, in a non-tension-bearing area, a few days to a week should suffice. If its on your back and you want to do heavy lifting, it could be three to four weeks, said Dr. Platzer. Follow your doctors advice.
How Do You Effectively Minimize Scarring After Mohs Surgery
Posted on January 14, 2014 in Laser, Skin Cancer, Practice News, How to Protect Yourself From the Sun
Scarring is always a concern with any skin surgery, especially if the procedure is on the face or another cosmetically sensitive area. No matter how old, no matter what stage of life my patient is in, this is something that always comes up, says Dr. Adam Mamelak, procedural dermatologist at Sanova Dermatology in Austin who uses Mohs micrographic surgery to treat skin cancer. Dr. Mamelak notes that the face is the most common area to develop skin cancer, along with other exposed areas such as the backs of the hands.
The good news is that Mohs surgery is designed to minimize scarring scarring at the outset, by creating the smallest post-surgical wound possible, explains Dr. Mamelak. This wound that remains after a skin cancer is removed is then taken care of in one of several ways. Depending on the wounds location and dimensions, a number of reconstructive options might be available, including stitches, skin flaps, skin grafts, ointments, silicone pads and pressure dressings to promote healing. In some instances, allowing the wound to heal naturally may also be an option.
Patience is key, says Dr. Mamelak. Patients need to understand that it takes up to 6 months for the skin to heal completely after a surgery. Rushing into an additional procedure such as dermabrasion or laser too soon can potentially worsen the final result.
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Scar Revision And Recontouring Post
Following Mohs reconstruction, several options are available to improve the appearance of the resulting scars. It is critical that the patient has realistic goals before beginning any treatment because scars can be improved but never erased. The surgical and nonsurgical options aim to replace pre-existing scars with ones that are less conspicuous. This article addresses the different available options for improving scarring following Mohs reconstruction.
Work With An Experienced Plastic Surgeon
Board certified plastic surgeons spend many years studying and training in both reconstructive and cosmetic surgery techniques. This gives them a unique perspective, and they can combine functional and aesthetic techniques to provide optimal results.
Plastic surgeons like Dr. Garazo who are experienced in skin cancer removal and have spent decades providing cosmetically pleasing surgical results are particularly well qualified to minimize scarring.
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Mohs Surgery Recovery Faq
If youre diagnosed with basal cell carcinoma or squamous cell carcinoma, theres a good chance your dermatologist will recommend Mohs surgery. In this technique, the surgeon removes cancerous tissue in stages, one layer at a time, until no more cancer remains. Besides offering a significantly higher cure rate than traditional skin cancer surgery, Mohs limits scarring and reduces the likelihood of needing additional treatment.
Mohs surgery is done in a single visit, and when you leave the dermatologists office, you can be confident that your skin cancer has been removed. But what happens after you go home? Here, Dr. Justin Platzer, a board-certified dermatologist and Mohs surgeon at Waters Edge Dermatology, answers the most frequently asked questions about Mohs surgery recovery, including wound care.
Possible Skin Cancer Recurrence
Skin cancer has a very small chance of coming back after a Mohs procedure. However, when that happens, further tests may be done to look for sites of spread. Recurrences are treated immediately and with a regimen that may be more aggressive than the first.
Your primary doctor or dermatologist will schedule you for yearly follow-up visits to check for new skin cancer. They may also advise you about self-examination techniques. Self-examination can help you spot a recurrence or distant spread even before your scheduled follow-up visit.
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How To Lessen The Appearance Of Your Plastic Surgery Scar
Scar maturation is an ongoing process. After your plastic surgery procedure, you can expect new scars to continue growing and changing for up to eighteen months. While this is normal, you may be concerned about the appearance of your scar, both through the healing process and permanently. Scar massage can be an effective way to decrease the buildup of scar tissue, making scars less noticeable. It should be noted that this method is only effective for newer scarring. It wont help soften scars that are more than two years old.
Scar : Faq About Scars
Did you know scars dont tanthey burn? The structural properties of a scar are different from regular skin. Scar tissue doesnt have melanin . In fact, scars are more susceptible to UV damage and get sunburned more easily than regular skin. Always put sunscreen on and cover your scar in the sun!
Q: What is a Scar?
A: A scar is a mark left on your skin after an injury or an incision. Scar tissue forms during the healing process as the body produces collagen fibres to close and heal a wound. These collagen fibres do not grow in the same, consistent direction, and therefore are discoloured and can have an uneven texture. A scab forms over the wound to protect the area from germs. Once healed, the scab will fall off and your newly formed scar will reveal itself. Is the human body cool or what?!
Q: When Does a Scar form?
A: There are three phases of wound healing and scar formation after an incision is made during a surgery or a deep wound is inflicted.
3 Phases of Wound/ Incision Healing:
Your scar will be visible after scabbing is gone. This usually happens 10+ days after an incision or a deep cut/ wound.
Q. What Determines the Appearance of My Scar?
Q: How Long Will My Scar Heal For?
For tips on healing your scar faster, check out our article Scar Healing, Size & Treatment After Joint Replacement Surgery.
Enough about the basics! Lets get into massaging scar tissue.
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The Pub Sub Was Worth The Outing
My first trip out was to Publix, which is a grocery store here in Florida. If you havent had a Pub Sub, as they’re affectionately known, you dont know what youre missing. Anyway, I went out. Yes, a few people stared, but it wasnt bad at all. I never felt embarrassed or ashamed of my face, but Im the type of person who thinks scars are cool.
Scar Tissue Massage: When Why & How
Before you start massaging your scar or enlisting a professional to perform scar tissue massage, your scar has to be in a good place. Do not massage until your incision has fully healed and is a scar . If you massage your scar prematurely you could cause it to reopen or tear, leading to an infection.
Do not massage a scar until at least 2 weeks after a surgery or injury. Massaging scar tissue is most effective in the first 2 years while the scar is still forming and healing.
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Can You Drive Home After A Mohs Procedure
For most patients, it is safe to drive home after the operation. Local anesthesia does not cause drowsiness, and the surgical wound is not expected to restrict body movement.
Still, if this is a concern, you may discuss it with your surgeon before you get discharged. At BHSkin Dermatology, patient safety is our top priority. Our doctors will give you a quick, thorough check before clearing you for driving and sending you home.
Do I Need Scar Revision
Some scars need intervention early in the healing process if they become thick and overgrow. If the scar is hypertrophic or becomes a keloid, then steroid injections may be needed.
Scars may benefit from surgical revision if there is significant contour irregularities or the orientation of the scar makes it more noticeable. Some strategies that Plastic Surgeons use to improve the appearance of scars are changing the direction of the scar to lie in natural skin creases or breaking up a straight line scar with Z-plasties or W-plasties.
If you would like more information about scar and wound management, please contact the Craniofacial Team of Texas by calling or toll free to schedule an appointment or complete an online appointment request.
Dell Childrens Craniofacial TEAM
1301 Barbara Jordan Blvd
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Treating Mohs Surgery Skin Cancer Scars
Mohs surgery is the most effective technique for removing Basal Cell and Squamous Cell , the two most common types of skin cancer. It not only removes all the cancer cells, but does so while sparing the greatest amount of healthy tissue around the cancer. Many Mohs surgeries are performed every year, and patients undergoing these procedures can benefit from knowing what to expect and how to prevent scarring afterwards. The procedure is named after Dr. Frederick Mohs, the physician who developed the process. Another major benefit is that this procedure can result in smaller scars, since the cancer is removed in layers rather than healthy skin being removed from the surrounding area.
Removal of skin cancers using Mohs surgery leaves behind a wound that is typically closed with stitches. If the surrounding skin does not offer enough mobility for stitches to be a viable option, then a skin graft may be used. This means that skin is taken from another area of the body and used to cover the wound. Alternatively, a skin flap may be used, in which the skin is shifted and moved in such a way that then allows stitches to be used. Finally, in certain cases, the wound can simply be left to heal on its own, although this can take a significant amount of time and generally results in a scar that is the same shape as the original wound.
Have a question about your scar? Leave a comment and well be happy to answer.
Will There Be A Scar
If your surgery is done on your face, this may be one of the first questions in your mind. The answer is yes, there almost always is a scar when you have Mohs surgery. One of the common regrets expressed on this site is that a plastic or reconstructive surgeon was not present to perform the closure of the wound. There are many people who may not need such a specialist but it is always wise to ask beforehand. Prior to your surgery always ask about your options regarding how the wound will be closed and also about how the scar can be minimized.
One of our most popular articles on skin cancer is an article written by Doctor Kevin Berman entitled: “” Here is an excerpt from that article:
“Silicone pads may help prevent hypertrophic scars although there is still no way to guarantee a perfect scar. Vitamin E containing creams and other creams designed to aid scarring may help but none have definitively been proven to aid the final outcome. If the scar is thicker than expected, you can talk with your surgeon about “dermabrasion” in which the skin is effectively “sanded down” to smoothen it and make the scar thinner. Scar revisions can also be performed in which the scar is excised or re-oriented to improve the final outcome.”
As always, check with your doctor about what treatments are advisable for you.
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My Relationship With My Scars
I embrace my scars, though I know that mentality isn’t for everyone. In fact, every other year or so, Ill share my photos. Some find it horrifying. Others are interested. The point is, its important that I had the Mohs surgery to get rid of the cancer. What I looked like at Publix that one day wasn’t important in comparison.
What Kinds Of Scars Develop
Your Mohs surgery scar will depend on the size, location, and shape of cancer, as well as the types of reconstruction techniques required.
In certain situations, when the cancer is small, the skin can be pulled together and sutured closed. This technique usually results in a minimal, thin line.
In other situations, when skin or cartilage graft is required, the resulting scar may be round or rectangular and be readily visible.
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The Need For Scar Treatments Or Reconstructive Surgery
Scar tissue formation does not slow down until the 6th month postop. Removal procedures may just worsen the scarring if done prematurely. So, it is best to wait until the 6th month after your Mohs surgery to assess the need for more aggressive scar treatments.
The dermatologist can take care of most scars resulting from a Mohs procedure. However, complex scars need revision procedures, which are in the realm of plastic surgery.