Q: Having recently had a mini-facelift7 and eyelift, I found your sit7e very useful and explicit. I had my surgery 5 weeks ago and the scars around the ears are more pronounced that say 2 weeks ago. I was quite alarmed and decided to search the internet for answers. I came across your site and have to say it was the only one that gave me the specific answers I needed for peace of mind. Thank you so much.
A: Undoubtably you are referring to the inevitable change in the appearance of most incisions that occur several weeks after surgery. This is the typical change from what appeared as an initially great looking incision to now a more red scar. Many patients understandbly think that something is wrong or that they have an infecion. In reality this is a normal biologic process and is part of the typical cascade of events that lead to wound healing.
While incisions make look fantastic during the first week after surgry, that is largely because little to no wound healing has actually occurred. The wound is only being held together by the stitches and the fibrin glue that the body naturally makes between the skin edges. It requires before the blood vessels grow into the tissues to supply the necessary elements that cause complete wound healing. It is the ingrowth of blood vessels into the scar that makes it turn red. Think of it as soldiers being amassed before an attack can occur. Once the wound is more fully healed, there is no purpose for the extra blood vessels and they go away…leading to the fading of the redness of the scar. This scar maturation process takes many months and can last up to a year after surgery. Although in the face it occurs much faster due to the already good supply which exists in the tissues. This is also why scar revision are often not recommended to be performed until all of the redness of the scar has subsided.
Dr. Barry Eppley
Q: I had a bullhorn lip lift three weeks ago and feel that the scar under my nose is quite hard (harder when I start talking) and still visible. Can you please tell me if the scar will soften and dissappear eventually? I much appreciate a second opinion.
A: The healing of scars from a surgical incision, as well as from any injury, is much different than most people perceive. When people see the dressings or tapes from a surgical incision, or the sutures placed to close it, removed a week or so later, they are often surprised how well it looks. When viewing the same scar weeks to a month later, it will look worse and some patients feel that something is going wrong.
In reality, this is part of the normal healing process. Actual healing of a wound or incision does even start to take place for weeks. That is why it looks so good just a week later, nothing is really going on and the body is not reacting fully to the insult. The scar will naturally turn redder and get firm weeks later as the body recruits the necessary elements to actually heal the incision. Blood vessels grow in and collagen is laid down to help knit the tissues back together. Collectively, this natural healing process creates a red and firm scar for months. Once the incision is getting more healed the redness fades and it will get softer, eventually getting that faded scar and softness of the tissues.
This healing process takes months and often is only complete at close to a year after the surgery. At this point, it will return to what it looked like at just a week or so after the initial surgery. When the incision is just under your nose, from a lip lift, one is forced to look at it daily. One’s awareness and uncertainly as to what will happen with it is understandably high.