How to Prevent or Minimize Surgery Scars

If you are planning to have surgery, you may be surprised to know that scarring can be reduced or prevented after your procedure. While some scarring is inevitable, you can help minimize scarring with good incision care and other methods of scar prevention.

This article explains the causes and risk factors for scarring after surgery. In addition, it offers suggestions for preventing scars and caring for your wound.

Causes of Surgical Scars

Whenever the skin is damaged, there is the possibility of scarring. For example, as a child, repeatedly skinning your knee may result in a scar that lasts a lifetime.

The same is true of surgery—even cosmetic surgery. That's because making an incision typically requires cutting through all of the layers of the skin. As a result, surgery often results in a scar, regardless of the following:

• Your surgeon's skill
• The incision location
• The reason for the surgery

Risk Factors for Scarring

Certain things beyond your control influence your ability to heal without scarring. Unfortunately, you can not change these risk factors, but knowing what they are can help you understand the likelihood of scarring after your procedure.

Your Age

As you age, your skin becomes thinner and less elastic. That is because collagen (which makes the skin flexible) reduces as we age. This change results in the fat layer under your skin becoming thinner. Therefore, skin does not heal as well or as quickly as we age.

In addition to collagen changes, some other things that make scarring more likely as you get older include:

• Sun exposure
• Smoking
• Pollutants

On the upside, the imperfections that occur over time, like dark spots and wrinkles, actually help conceal scars that might be more obvious on younger skin.

Your Race

Some races are more likely to scar. For example, people of African descent are more likely to form hypertrophic and keloid scars. These scars are an overgrowth of scar tissue at the site of an injury.

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In general, scars typically remain very thin. How light or dark they appear depends on your skin color. For example:

• Light skin: Scars are typically close to an exact match to the surrounding skin color and often fade away with time on people with lighter skin.
• Dark skin: Those with darker skin may notice that their scars are darker than the surrounding tissue.

Genetic (Inherited) Tendency to Scar

If your parents or siblings tend to scar heavily, you are likely to do the same. Therefore, if you have a family tendency to scar badly, you may want to discuss this with your surgeon.

Size and Depth of Your Incision

A large incision is much more likely to leave a scar than a small one. The deeper and longer the cut, the longer the healing process and the greater the opportunity for scarring. That's because a larger incision may be exposed to more stress as you move, which can cause slower healing.

How Quickly Your Skin Heals

You may be one of the genetically blessed people who seem to heal quickly and easily with minimal scarring. Or, you may have skin that tends to heal slowly.

Sometimes slow-healing skin can be the result of an underlying medical condition, like diabetes. Regardless, how quickly you heal is individual and can change with illness or injury.

Prevention

The good news is there are some factors you can control, which may help you prevent scars. Some ways are simple, like following the instructions your surgeon gives you to the letter. Others, like smoking, are not so easy.

Quit Smoking

Not only does smoking increase your risk for scars, but it can also slow your overall healing.

Smoking is such a significant risk factor that some plastic surgeons will not operate on a person who does not quit smoking altogether for at least two weeks before surgery.

So, to reduce your risk of scarring and surgical risks, quit smoking.

Stay Hydrated

Dehydration happens when you are not taking in enough fluids. In severe cases, this can cause electrolyte imbalances and heart problems. In less severe cases, you will feel thirsty and generally unwell.

So, stay well hydrated to feel your best and create the optimal environment for healing. You will know if you are well-hydrated when your urine is almost colorless or light in color. 

Improve Nutrition

Protein makes up the building blocks of healing skin. Therefore, it is essential to provide your body with adequate protein to allow your skin to heal. So, eat a balanced diet with an emphasis on protein.

Some common protein choices include:

• Chicken
• Pork
• Fish
• Seafood
• Beef
• Dairy products
• Nuts and legumes

Maintain a Healthy Weight

If you have excess weight, you may be at greater risk of scarring. That's because the fat under your skin can work against your surgeon's best efforts to close your incision seamlessly.

Manage Chronic Illness

Diabetes and many other illnesses can slow healing. For the best possible outcome, be sure your condition is well-controlled before surgery and during your recovery.

For example, high glucose levels slow healing. So, if you have diabetes, work hard to keep your blood glucose levels within normal limits.

Healing and Wound Care

In addition to preventative measures, you can also take steps during your recovery that may help minimize or prevent scarring. For example, good incision care to prevent infection is one of the best ways to prevent scarring after surgery.

Incision care includes:

• Rest: If your healthcare provider suggests that you rest for two weeks, resist the urge to go back to work after one week of healing. Exhausting yourself can slow recovery.
• Perform proper wound care: Taking the steps your surgeon recommends may be the most critical thing you can do to prevent scars. So, avoid ointments and other remedies unless your doctor prescribes them, and follow other general incision care techniques to increase the likelihood of healing without scars.
• Identify infection quickly: Seek help from your healthcare provider immediately if you notice any signs of infection. An infection can seriously impair healing and contribute to scarring.
• Reduce stress on your incision: Avoid lifting, bending, or doing anything that stretches or puts tension on your incision, including driving. This stress can pull the incision apart and delay healing. Often this makes the wound larger than it needs to be, which increases the size of your scar.
• Avoid exposure to sunlight: Keep the sun off your incision whenever possible. If your scar is in a place that is difficult to cover, such as your face, use sunscreen after your incision heals. Your surgeon can tell you when to apply ointments, but it is usually safe to do so when the sutures are removed, or the incision has closed completely.

Surgical Scar Treatments

If you are concerned about scarring, consider discussing scar minimization and prevention with your surgeon. Your surgeon may be able to prescribe additional treatments that lower your chances of scarring.

Silicone Wound Treatment

Silicone wound dressings feel similar to a thick plastic wrap that you would use in the kitchen. There are a couple of ways to apply silicone dressings, including:

• Silicone sheets: These are applied directly to the wound and stay there.
• Silicone gel: This is applied directly over the scar and is left dry in place.

Studies have shown that silicone can help reduce scarring, and surgeons commonly use them after plastic surgery. Ask your surgeon if silicone dressings are a good option for you.

Incision Placement

In some surgeries, your surgeon can modify incision placement to reduce scar visibility. You may be able to talk to your surgeon about where they place the incision to either hide or help minimize scars.

For example, doctors can perform a cesarean section with a vertical incision, which may be more pronounced, or a horizontal incision, which a bikini may disguise.

Prescription Medications

If you tend to scar badly, your surgeon may be able to prescribe cleansers, ointments, or a wound care routine to help.

Massage

More healthcare providers are recommending scar tissue massage. Physical therapists typically perform this type of massage. But, be sure to wait until after the wound closes and any staples or sutures are removed.

Massaging an incision and the surrounding tissue may even out any bumps or lumps that remain after the healing process. Your physical therapist can usually show you how to massage your scar at home. Be sure to use ample lotion so that your fingers don’t “stick” to your skin but slide freely.

Steroid Injections

If you are prone to forming keloid scars, talk to your surgeon about having a steroid injection. Steroids may help prevent the formation of another keloid.

Summary

Some scarring after a surgical incision is inevitable. But, there are some things you can do to prevent or reduce the visibility of scarring. In addition, post-surgical wound care can also contribute to a scar that heals optimally.

A Word From Verywell

Scarring after surgery varies widely from person to person. For example, one person may have a procedure and have virtually no scarring, while another may have a notable scar. 

If you're concerned about scarring or want to be vigilant about preventing severe scarring, talk to your healthcare provider about it. Even if you're not worried about scarring, remember that good incision care is still crucial for healing and preventing infection.