The purpose of cosmetic surgery in this manner improves one’s self-perceptions and quality of life by giving them assurance (and reality) that they look better after surgery. Among the various treatments included are topical ointments, cryotherapy, laser skin resurfacing, dermal fillers, medicines and scar excision surgery.
Before moving on to scar minimization treatment; the reader will first take a brief look at how scars are formed in the process of wound healing. A scar formation process progresses in three stages.
This phase is the initial body’s response to a wound or injury that punctures the skin or even happens inside. It is felt by swelling, bruising, tenderness and heat in the area which is initiated to deter foreign microbes, germs, agents or bacteria that may transfer to vital internal tissue because of the wound – which may very well be a surgical incision. Numerous body made agents are circulated in the wound area during this phase triggered by trauma and complementing the start of the healing process. These include monocytes and macrophages (these are white blood cells), platelets, plasma rich blood cells, protein chains and antibodies. The inflammation phase is a transient phase and it only serves a purpose for the coming phases. Inflammation that remains means that foreign object has entered the body and the body is actively fighting it. Professional help is necessary in this case.
The second phase involves the clotting and wound closing actions of the body through fibroplast proliferation at the bottom of the wound. Specialized cells that create a mesh for the blood clot to fill the wound are responsible for the production and spreading of granulated scar tissue. At first certain collagen fibers are rapidly produced for the structure that is later on replaced by other collagen fibers in the next phase. The production and visible layering of granulation tissue are further reinforced through the body’s release of cytokine from motile fibroblasts and activated WBCs. The basic scaffolding structure is laid down in this phase allowing for granulation to deposit and grow on the extracellular matrix structure, moving on to the next phase.
This final phase is where the scar tissue made up of a network of collagen fibers that were deposited before the previous phase go through a slow remodeling process in the whole wound healing course. Such remodeling may continue to actively take place for up to a year after trauma. But the main time period of wound healing in this phase usually takes less than a month. Collagen is no longer deposited in this phase but collagen is replaced with another type of collagen as the body continues to try and repair the extracellular matrix structure in a more orderly and eventually normal arrangement of fibers to strengthen the elasticity and tone of the wound area. When this phase is finished scar tissue remaining behind successfully reinforces the wound area by 70 to 80 percent of the original skin strength.
For a more aesthetically pleasant change in the outlook of a person’s scars, the surgeon seeks to match the scar’s texture, color and elevation to that of the neighboring skin so as to make it imperceptible. For instance scars in hair bearing areas may be very obvious because scars lack the sub-dermal structures normally present in normal tissue that is destroyed through that trauma that causes the scar. These include hair follicles, sweat glands, and other tiny down growths that grow in towards the body. On the other hand a scar where there is very less hair can be used to and advantage and treated through a different approach in order to disguise it.
Patient factors also dictate a lot in scarring and its treatment. Factors such as immediate care, wound closure, products used and wound hygiene make a difference in the scar appearance. It is often heard that people who are older can get scarred to a larger degree than younger patients. Although that is a myth since no irrefutable evidence has been brought forth in medical literature to compound that theory; it is an indication that scars heal differently for everyone and a lot depends on the person’s external factors.
Surgeons will probably have to look into the wound care that was conducted in order to better approach the scar involved. Scar minimization also can increase in difficulty with patient’s anatomical, biological and lifestyle factors such as disease, steroid intake, diabetic level, vitamin deficiency and habits such as smoking, or strenuous work during the wound healing period. Keloids can form on people mostly belonging to a certain genetic group but are also reported to have been intensified due to the patient not giving up on tanning for instance (UV exposure can lead to greater scar damage).
Minor technical details related to wound closure ultimately play major roles in scar formation. Added trauma to the wound during closure can result in skin necrosis leaving dark pigmented scars. Scabs peeled off may result in puckering of the skin and lighter pigmentation (which will eventually fade away) but interferes with the healing phases and can result in lesser tensile strength eventually. Wounds that become infected can leave permanent scars and excessive pressure while suturing a wound close can cause excessive production of collagen and more scar tissue. Other common factors that result in wider scars, loose skin and pigmentation or discomfort in wound area are wound closure under unnecessary tension, disregard to placing stitches along naturally relaxed skin folds in the scaffolding structure, improper nutrition technique or hygiene.
Luckily for patients undergoing wound healing scar minimization techniques are extremely modern and diverse in Dubai. Book a free consultation with one of our specialists simply by sending an online query to find a mental and physical solution right away!