Incision management and tips to ensure the best scar possible

How do I manage my incision and then what can I do to ensure the best scar possible?  A common question and a source of lots of confusion both for patients and even for medical professionals is how can we ensure the best healing from surgery, reduce the risk of complications like infection and the incision pulling apart and ultimately what can be done during the healing process to ensure the best possible scar.

Let us start with what can be done before surgery to maximize results. In general, having a balanced diet, keeping your blood pressure and diabetes under good control, and for facial surgery like a face lift using sunscreen regularly as well as using medical grade skin care before (and after) surgery will maximize results and reduce complications. I would caution people from using products such as arnica as this may cause bleeding during surgery and of course if you take aspirin or other anti-inflammatories, they should be stopped 10 days before surgery to reduce bleeding risk.

A word about smoking….

The effects of smoking (even one cigarette, including e-cigs, nicotine gum, patches, and weed) on wound healing and skin healing have been well documented in the medical literature and are very well understood. Nicotine and other chemicals in smoke cause blood vessels to narrow which means less blood supply to the skin which means slower and poorer healing. Now, this doesn’t mean you can’t have surgery if you smoke, surgeries in which not a lot of skin release is being done or there is very little tightening like breast augmentation, eyelids, rhinoplasty, and liposuction are doable with lower risks.

However, tummy tucks, breast lifts, neck lifts, and facelifts specifically should not be done in people actively smoking and again there is very good evidence to show that skin loss and infection are very high risks. You don’t want to pay money to have an elective surgery to make you look better and have the skin die or the incision open requiring weeks and months of dressings and even nursing home care.

So what can be done?…..Well, if a patient can stop smoking 4-6weeks before surgery (not even one cig) and another month after surgery while they are healing, the bad effects of cigarette smoke are reversed. Smoking after this period of time is perfectly fine from a healing perspective.