Linda Briggs Cosmetic Surgery & Dentistry

Index

Cosmetic or Plastic Surgery  Scars

Scars | Operative | Trauma | Hypertrophic | Keloid | Burns | Stretch Marks

Especially for children all about scars

An American information site on scars

Specialist site for Burns victims

Smallpox scars and acne scars can sometimes be filled under the skin with a dermal filler to make the skin inside the scar the same height as the rest of the skin and therefore not be so visible.  See that section for more information on the different products available.

For some people a scar is a cosmetic problem they would sooner be without, while for others, it provides a constant reminder of something they would sooner forget.  It must be remembered that scars can never be removed completely.  Scar formation is the normal way for the body to repair itself.  The way it is treated from day one, however, will dictate what type of scar is left; either a flat, white, mature scar or a lumpy, hypertrophic, unsightly scar.  The use of products can ensure maturity if a scar as quickly as possible.

NEW SCARS  Once the sutures are removed from a new scar it is ready to be treated.
The initial stages of scar healing are crucial and the way they are treated dictates whether or not the end result will be acceptable. You need a product with wound and scar healing, anti-inflammatory and repairing ingredients, as soon as possible.

TREATMENT & PREVENTION
The management of a scar after an operation is as important as the operation itself in achieving an optimal final result.  To this extent the individual has a certain control over the final result, as the technique used following surgery (or trauma) involves setting the ideal environment for healing and trying to influence the aggressiveness with which healing occurs

A glass cut at 8 days. The day the stitches removed. Contracted, thickened, unsightly scars have until now been something that many people have just had to learn to live with.  Many methods of scar maturing and flattening have been tried with limited success.  These have included pressure dressings, silicone sheeting, splints, steroid injections and radiotherapy.

Taped for one week.  These have not always been without the possible side effects of irritation and pain and in some cases have been time consuming, very costly procedures.

Cream applied daily for 8 weeks without tape. Through many years of researching products and techniques for decreasing scar formation it has been found that when certain factors are combined, one may reduce the maturation time of a scar, achieving a more acceptable cosmetic appearance.

Inflammation
Swelling of the immediate scar area is inevitable as a result of the activity of various cell hormones released in and around the fresh scar.  Too much swelling and resulting increased permeability of the immediate scar area can result in the accumulation of a highly concentrated fibrogen gel, which can mature into a thick, dense, binding scar. In some cases the inflammatory phase may go on for months and even years leaving the patient with a swollen, red, warm and painful scar.  It is essential therefore, that excessive inflammation be prevented during scar treatment.

Healthy Enhanced Wound Healing
It is the primary function of the clinician to first apply basic techniques to ensure wound healing.  This involves the usual support of the wound (taping, stitching, immobilisation, antibiotics etc).  It has been found, however, that even mild to sub-clinical shortages of pantothenic acid in tissue, resulted in poor wound healing.  Pro-Vitamin B5 tadded to a formula ensures sufficient amounts of pantothenic acid in the immediate wound area to enhance wound healing.  This, combined with the healing properties of arnica and St John’s Wort, helps promote more rapid and healthy wound healing.

Increased Collagen I Synthesis with Anti-Keloid Effect
The Centella Asiatica plant, indigenous to Southern Africa, is renowned for its wound healing properties and as a prevention of keloid (ugly scar) formation. Some products have been formulated with the triterpenic fraction from Centella Asiatica carried in phospholipid liposomes.   Liposomes consist of micro “hollow” fatty droplets, containing the active ingredients.   These liposomes are known to penetrate deep into the skin, carrying with them the active Centella components, along with other powerful ingredients.   Once into the skin, the liposomes “fall apart”; thereby releasing their valuable load into the cell.   Centella exhibits wound healing and anti-inflammatory activities with a group of triterpenes called asiaticosides which possess strong antioxidant properties and which stimulate the formation of lipids and proteins necessary for healthy skin. Combined with hydration with the promotion of enhanced wound healing.   Centella has the ability to influence the inflammatory process in wound healing.   It promotes Type I and Type III collagen homeostasis.   An immature, thickened scar is characterised by a prolonged inflammatory phase and an abundance of Type III collagen.  Centella helps promote balanced collagen production, achieving improved wound healing and scar formation.   Scientific literature indicates Centella may stop the conversion of the mature fibrocytes to myofibroblasts, which is the cell type known to be associated with thickened, keloid type scars.

Control of Stretching Forces
Scars undergoing constant tension, movement and stretching may result in broader scars or scars that remain immature and become hypertrophic.  A scar needs to mature as quickly as possible without thickening and contraction (when too much collagen is formed).
For this to be possible, one should apply a contact medium, applying pressure and allowing the powerful Centella to penetrate and heal the wound. A perfect contact medium (paper tape) is one which allows hydration and healing.

In clinical practice, a reduction in scar width has been shown with continuous taping as opposed to having the scar untaped.    The application of a paper tape applies sufficient pressure to support the wound and thus help prevent stretching.   The tape should be micro-porous, applying pressure while allowing penetration of the wound healing ingredients in the Centella Scar Cream.   The tape is then impregnated with the potent Centella Scar preparation and so works as a slow release medicine to the scar.