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Result of any surgical procedure is scarring. Each and every time the skin
is cut either by scalpel or laser a surgical scar is produced. The quality and
appearance of scars vary widely with the individual's healing process, the
position of the scar on the body, and the degree of tension placed on the
scar. The types of scars can be influenced by personal, familial and
racial factors and cannot be controlled by the surgeon.

It is the plastic surgeon's ambition to try to hide scars as far as possible
or to camouflage their existence. With some operations the scar will
always be visible. With some areas on the body there is an unpredictable
healing response of the scar. Some patients form hard, red, thick
hypertrophic scars which cannot be anticipated by the surgeon before
the operation. The type of scarring which has been produced by previous
surgery MAY give an indication to the type of scarring that might result.

Some forms of surgery will predictably produce good scars such as the
scar in front of the ear when face-lift surgery is performed. Other operations
such as breast reduction or abdominal surgery produce scars which are
frequently prone to stretching, thickening, redness and tenderness. In
the worst cases, these scars will take one to two years to reduce
in thickness and will never end up as thin line scars. The degree of
stretching depends on personal healing qualities and the area on the
body where the incision is located.

Scars will nearly always mature and flatten, but the time interval for this
to occur is variable, from several months to several years. In the worst
instance a keloid scar may develop which will remain raised, red, thick,
tender and itchy, and despite various treatments might recur.

Surgical scars, when settled or mature, are always white (they contain
no pigment producing cells) but occasionally with more superficial skin injury
such as dermabrasion or chemical peel the scar can over pigment. This is
usually due to sun exposure but can exacerbated with certain skin types, oral
contraceptive pill (and other hormone treatment) and certain drugs. It is
always important in the early stages to protect the scar from sun exposure.

Scarring also occurs in the deeper layers of skin, fat and muscle. This is
more prominent when the skin or other layers have been separated and
these scars can behave in the same manner as skin scars, becoming
thick, lumpy, raised and tender. As with skin scars, this type of scarring
will settle or mature with time but the process may take many months.
The most noticeable areas where this deeper type of scarring can occur
is in the cheeks of the face-lifts or after liposuction. Massage and other
types of treatment can help and flattening the scar, but time is always necessary.


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