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When contemplating a cosmetic procedure, we spend so much time researching everything we can about the surgery – its benefits, [downtime](https://aedit.com/aedition/best-plastic-surgery-recovery-nurses-centers-products), side effects and [complications](https://aedit.com/aedition/guide-to-cosmetic-surgery-complications), and what we can realistically expect to achieve from it. In the case of surgical procedures, a piece of the puzzle that you may overlook is what kind of incision (or incisions) are involved. Any time there is an incision, there will be a scar. Other than genetics, one of the most important factors – especially in the first few days and weeks post-op – in determining what that scar will look like? Tension. 

While the skill of your board certified plastic surgeon will go a long way toward reducing tension and ensuring as inconspicuous a [scar](https://aedit.com/concern/scars) as possible, what you do in the aftermath of your surgery plays a large role in how incisions ultimately heal. If you’re considering a body cosmetic procedure or already have one scheduled, you’ve come to the right place. Read on to learn expert tips on what you can do post-op to ensure your incisions heal optimally and your scars are as minimal as possible. 

## **The Role of Tension in Scarring**
Late last year, we ran an article on the [kind of scarring you can expect from popular body procedures](https://aedit.com/aedition/scarring-after-body-plastic-surgery) (if you haven’t checked it out, you might want to read it first). One of the things that came up time and time again in our discussion with plastic surgeons was the idea of tension and how it impacts scarring. That gave us the idea to explore the topic further because, as it turns out, both the surgeon and the patient have control over how much ‘tension’ an incision site experiences.

In the healing sense, tension refers to any force that pulls the wound apart, says [Umbareen Mahmood, MD](https://aedit.com/provider/umbareen-mahmood-md-23), a board certified plastic and reconstructive surgeon in New York City. When there’s too much tension on an incision, “it is at risk of widening or completely separating,” warns [Lauren Chmielewski, MD](https://aedit.com/provider/lauren-chmielewski-md-143), a NYC-based board certified plastic and reconstructive surgeon. The former increases the likelihood of a wider scar, while the latter results in an open wound.

There are many ways to limit tension on post-surgical incision sites, and they start in the operating room. “As plastic surgeons, we do a thorough multi-layer closure, which means closing each layer of tissue to reduce stress on the top layer of skin (the final scar),” Dr. Mahmood explains. “We also work to leave a meticulous fine line final skin closure.”

And then there is what the patient can do at home. “The best way to care for a healing scar is to follow your surgeon’s after-care instructions and keep your post-operative visits,” Dr. Chmielewski shares. While the directions vary a bit by provider, they generally include:

- Keeping dressings in place
- Wearing protective or [compression garments](https://aedit.com/aedition/benefits-of-compression-garments-after-cosmetic-surgery)
- [Activity restrictions](https://aedit.com/aedition/when-to-start-exercising-again-after-cosmetic-surgery-procedures)
- Abstaining from [smoking](https://aedit.com/aedition/impact-of-cigarette-smoking-vaping-on-skin-hair-teeth-health)
- Limiting movement of the treatment area

“These are all directions that should be followed closely, as they can affect the ultimate outcome of the scar,” Dr. Chmielewski notes. It goes without saying, but don’t skip out on follow up appointments with your surgeon. They are a time for you to ask any questions and for your provider to monitor your recovery process. “Ultimately, having an experienced pair of eyes monitoring the healing is important, too,” she adds.

## **How to Reduce Tension & Minimize Scarring**
Now that you have a better sense of the role of tension in the scarring process, it’s time to talk about what it means for specific cosmetic surgeries. Below is a break down of expert tips for [minimizing tension and scarring](https://aedit.com/aedition/minimizing-scars-after-surgery) after some of the most popular body procedures:

### **Abdominoplasty (a.k.a Tummy Tuck)**
An [abdominoplasty](https://aedit.com/procedure/abdominoplasty), or tummy tuck, removes unwanted skin and fat and tightens the muscles of the abdomen. The scar, which is usually concealed below the bikini line, typically extends from hip to hip. “A tummy tuck, by definition, is going to be a somewhat tight closure,” Dr. Chmielewski says. To limit abdominal movement, any activities that use your core – including lifting, pushing, and pulling – should be avoided for at least two weeks. During that time period, you’ll also want to be mindful of your posture. She recommends maintaining a “beach chair” position, “as not to fully extend and stretch out the torso.”

Need a visual? When laying down, use [pillows](https://aedit.com/aedition/best-pillows-for-plastic-sugery-recovery-healing) to prop up the upper body and lower legs (similar to sitting in a beach chair), so that there is a gentle bend of 20 to 30 degrees at the hips. Sitting in a recliner has a similar effect. The goal is to take pressure off the abdomen and avoid laying flat. When standing, now is not the time to channel your inner ballerina. Hinge at your hips and refrain from standing up straight.

<BeforeAfterModule
  title={Before & Afters: Tummy Tuck}
  procedureId={840}
/>

### **Brachioplasty (a.k.a Arm Lift)**
A brachioplasty (a.k.a. [arm lift](https://aedit.com/procedure/arm-lift)) sculpts the upper arm by removing skin and fat. The incision generally extends from the axilla (armpit) to the elbow and, depending on the surgeon, can be placed on the back of the arm or the inner arm crease. In either case, minimizing tension is tough because of how much we use our arms. “It’s obviously impossible to tell a patient not to move their arms for one month after an arm lift,” Dr. Mahmood admits. “But there are certainly movements they can be mindful of.” 

For starters, keep hair styling (think: blow drying, ponytails, etc.) and other sweeping motions to a minimum because repetitive movements that involve extending the arms can cause the scar to widen. “Even small things – like wearing a bra that closes in the front – is helpful in the first month post-op, so that a patient doesn’t have to stretch their arms behind their back,” she explains. 

Her suggestion for optimal healing: Keep the arms at your side as much as possible and do any unavoidable tasks with your forearm and hand (instead of the whole arm). 

<BeforeAfterModule
  title={Before & Afters: Arm Lift}
  procedureId={787}
/>

### **Breast Surgery** 
There are (obviously) big differences between [breast augmentation](https://aedit.com/procedure/breast-augmentation-solutions), [breast lift](https://aedit.com/procedure/breast-lift-solutions), and [breast reduction](https://aedit.com/procedure/breast-reduction-and-revision-solutions) surgeries when it comes to the purpose of the procedure. They also all involve unique incisions. “The biggest scar burden is with a reduction,” Dr. Chmielewski says. “A lift usually has more of a ‘lollipop’ incision, and an augmentation has the smallest scar.” Breast augmentation incisions can be in the inframammary crease (i.e. under the breast), periareolar (read: around the areola), or in the armpit. 

Even so, the way in which you go about reducing tension in the area is similar for all three. “Generally, the patient is to avoid any heavy lifting, pushing, pulling or upper body workouts for two weeks,” she explains. Refrain from raising your arms above your head during this period, too. When it comes to the breasts themselves, wearing a supportive (non-underwire) bra that provides the right level of compression is key to keeping everything in place.

To minimize tension while laying down, breast surgery patients are usually encouraged to elevate the head and upper torso. A [wedge pillow](https://aedit.com/aedition/best-pillows-for-plastic-sugery-recovery-healing) can get you into this semi-fowler position (meaning your back is at a 45 degree angle), and it also helps improve drainage and swelling. Beyond that, many doctors recommend placing a pillow or bolster under the knees to take pressure off the low back.

<BeforeAfterModule
  title={Before & Afters: Breast Reduction}
  procedureId={801}
/>

### **Liposuction & Fat Transfer**
[Liposuction](https://aedit.com/procedure/liposuction) is the gold standard of fat reduction, and it tends to be minimally invasive as far as incisions are concerned. As Dr. Mahmood explains, they are usually small (approximately 3 millimeters) and well-hidden. In abdominal liposuction, for example, incisions are usually concealed low in the bikini line and in the umbilical hood. “They heal well with no issue,” she notes. It should be noted that heat-based lipo modalities (like [VASER](https://aedit.com/procedure/ultrasound-assisted-liposuction) or [SmartLipo](https://aedit.com/procedure/smartlipo)) carry a higher risk of scarring.

While tension is less of a concern after liposuction due to the size of the incisions, you may be encouraged to [sleep on your back](https://aedit.com/aedition/sleeping-better-after-cosmetic-surgery-aesthetic-procedures) to maintain an even distribution of weight. Creating bumpers around yourself with pillows can help you from turning over. If you have fat removed from your arms or legs, keep the limbs elevated to ensure proper blood flow and minimize swelling.

Depending on your aesthetic goals, the fat removed via liposuction can be purified and transferred to another part of the body via injections (à la a [Brazilian butt lift](https://aedit.com/procedure/brazilian-butt-lift)). The fine needles used to inject the fat rarely result in external scars, though there might be other aspects of recovery to keep in mind.

<BeforeAfterModule
  title={Before & Afters: Liposuction}
  procedureId={1021}
/>

### **Thigh Lift**
The purpose of a [thigh lift](https://aedit.com/procedure/thigh-lift) is to remove excess skin and fat and reposition underlying tissue to lessen the appearance of sagging. The incision usually runs along the inside of the leg and the groin crease, which can be problematic for healing for several reasons. “There is often a lot of tension after a thigh lift,” Dr. Chmielewski confirms. “Compression is absolutely critical to control [swelling](https://aedit.com/aedition/how-to-treat-minimize-swelling-after-cosmetic-surgery) and prevent shear forces from pulling at the incisions.” 

Wound care is part of any recovery, but it’s especially important post-thigh lift due to the treatment region. “Good wound care is also important, as the incision can be in close proximity to the groin, a notoriously high-bacteria area,” she explains. “Infections prevent healing and can ultimately create a very bad scar.  

It can be nearly impossible to eliminate all tension after a thigh lift, but there are some steps you can take to relieve as much pressure as possible. “Everything that engages your legs, unfortunately, puts tension on a thigh lift scar,” Dr. Chmieleski shares. “While gentle activity – such as walking – is encouraged, there is no cardio heavy pushing, pulling, lifting for at least two weeks.” When standing, try to keep a slight bend at the hips for the first seven days or so.

<BeforeAfterModule
  title={Before & Afters: Thigh Lift}
  procedureId={823}
/>

## **The Takeaway**
Finding a board certified plastic and reconstructive surgeon who [specializes](https://aedit.com/aedition/finding-the-right-plastic-surgeon-dermatologist-or-cosmetic-dentist) in the body procedure you are interested in is critical to any successful cosmetic surgery outcome, but what you do (and don’t do) in the post-op period also has a lot to do with how you heal. To minimize scarring after any procedure, don’t forget to keep bandages in place and wear post-surgical garments as per your surgeon’s instructions, Dr. Chmielewski says. And, once you’re cleared to do so, invest in skincare. As she explains, “using a high-quality [scar cream or silicone tape](https://aedit.com/aedition/scar-minimizing-skincare-to-use-after-surgery) to optimize the scar is also helpful.”

Aesthetics

We’ve got expert tips on how to sit, stand, and sleep in the aftermath of cosmetic surgery to optimize results.

How To Reduce Tension After Cosmetic Surgery To Minimize Scars

How To Reduce Tension And Scarring After Body Procedures

shutterstock 612400328

If you’re thinking about undergoing a cosmetic procedure, you are probably wondering what you can realistically expect from the outcome. One aspect of the result that is easy to overlook is [scarring](https://aedit.com/concern/scars). The fact of the matter is: Any time there is an incision, there will be a scar. While there are some things you can’t control when it comes to the healing process (hi, genetics), there are some things you can do — from choosing a highly skilled surgeon to proper scar care — to ensure your incision(s) heal as optimally as possible.

To better understand what types of scars can result from body surgeries — and the best ways to treat them — we’ve asked the experts (and, if you're interested in a procedure above the neck, check out our [guide to facial plastic surgery scars](https://aedit.com/aedition/scarring-after-facial-plastic-surgery)).

## **Scarring After Body Procedures**
There are two main factors that determine how surgical incisions heal. One you can control, and the other you can't. “The most important factor in scarring is genetics,” says [Jacob Unger, MD](https://aedit.com/provider/jacob-unger-md-2649), a board certified plastic and reconstructive surgeon in Nashville, TN. “This, unfortunately, is not something any doctor or patient has control over, but it is the most prominent deciding issue when identifying how well someone scars.”

This is true regardless of the procedure, and your medical history should shed some light on how your plastic surgery recovery will go. “For all surgeries — abdominoplasty, brachioplasty, breast surgery, etc. — the primary factor that impacts how a scar heals is the patient’s own wound healing,” says [Umbareen Mahmood, MD](https://aedit.com/provider/umbareen-mahmood-md-23), a board certified plastic and reconstructive surgeon in New York City. “Some patients form [keloids or hypertrophic scars](https://aedit.com/aedition/how-to-treat-every-type-of-scar) with any trauma to the skin, whereas other patients heal with imperceptible scars.” 

The second part of the healing equation is the one you do have a say in. “Surgical technique is a key component to an optimal scar outcome, including types of suture use and how the tissue is handled,” Dr. Mahmood says. Choosing a [board certified plastic surgeon](https://aedit.com/aedition/finding-the-right-plastic-surgeon-dermatologist-or-cosmetic-dentist) who specializes in the procedure you are interested in will go a long way. “All scars heal best under less tension, but the problem, of course, is that patients want to be pulled tight for the best result,” explains [Michael Frederick, MD](https://aedit.com/provider/michael-frederick-md-643), a board certified plastic and reconstructive surgeon in Fort Lauderdale, FL. “It’s the good surgeon’s ability to be able to balance these factors to create the tightest result with the best scar.”

With all of this in mind, below is a break down of the incisions required of some of the most popular body procedures:

## **Abdominoplasty (a.k.a. Tummy Tuck)**
Also known as a tummy tuck, an [abdominoplasty](https://aedit.com/procedure/abdominoplasty) is a surgery that removes unwanted skin and fat and tightens the muscles of the abdomen. “The scar generally extends from hip to hip in order to remove the excess skin in these areas,” Dr. Mahmood says. “Multiple layers of stitches help take tension off the top layer of skin — which is where the scar is — to ensure a fine line scar.” While the length of the incision and subsequent scar is significant, it is strategically placed. “Abdominoplasty scars should be very low and well concealed below the bikini line,” she adds.

<BeforeAfterModule
  title={Before & Afters: Tummy Tuck}
  procedureId={840}
/>

## **Brachioplasty (a.k.a. Arm Lift)**
A brachioplasty, or [arm lift](https://aedit.com/procedure/arm-lift), is a surgery that contours the upper arm by removing skin and fat. As Dr. Mahmood explains, arm lift scars “tend to be one of the more difficult scars for some patients to accept because they can widen or become hyperpigmented.” This is because the arms are such an integral part of just about every motion we make. “Activities as simple as putting hair up in a ponytail or putting on a bra can cause tension on the scar,” she notes. 

<BeforeAfterModule
  title={Before & Afters: Arm Lift}
  procedureId={787}
/>

With that said, the incision generally extends from the axilla (armpit) to the elbow. “Some surgeons choose to place the incision at the back of the arm,” she says, noting that she likes to put it in the inner arm crease. “In this location, it is not visible when the patient's arms are at their side or in a relaxed communication position,” she shares.

## **Breast Surgery**
While augmentation mammaplasty (read: [breast augmentation](https://aedit.com/procedure/breast-augmentation-solutions)) remains one of the most popular cosmetic procedures in the United States, it’s not the only type of breast surgery. Below is what you can expect from the most common breast procedures:

### **Breast Augmentation**
[Breast augmentation with implants](https://aedit.com/procedure/breast-augmentation-with-implants) is a procedure that allows for quite a bit of customization. [Patients choose](https://aedit.com/aedition/how-to-choose-the-right-breast-implants) the type and general size of the implant they are interested in, and the surgeon will insert the implants using their preferred technique. “This surgery typically has a very small scar — one to two inches — along the undersurface of the breast along the fold or possibly in the areola or under the arm,” Dr. Unger explains. He personally prefers the “under breast approach” because, with “proper positioning, delicate tissue handling, and meticulous closure technique,” the scars “can commonly be made to be nearly invisible once healed.”

<BeforeAfterModule
  title={Before & Afters: Breast Implants}
  procedureId={1013}
/>

### **Breast Lift**
Unlike a breast augmentation, a mastopexy (a.k.a. [breast lift](https://aedit.com/procedure/breast-lift)) requires a more prominent incision. There are an [array of techniques](https://aedit.com/aedition/mastopexy-breast-lift-after-pregnancy-breastfeeding) depending on the degree of ptosis (read: drooping), but it can often involve a vertical incision from the nipple to the lower border of the breast fold. In Dr. Unger’s estimation, this scar tends to be “concerning” for patients because “it is visible along the lower pole of the breast.” 

<BeforeAfterModule
  title={Before & Afters: Breast Lift}
  procedureId={800}
/>

With the right care, however, it can be greatly minimized. “At least in my experience, this scar almost always heals incredibly well, and is usually imperceptible for most patients after a healing period,” Dr. Unger says. “For some this means it's almost invisible by three months; for some it's more like one to two years.” Regardless of which camp you fall into, “it almost always fades away to a level that is difficult to identify it at all,” he adds.

### **Breast Reduction**
For Dr. Frederick, the pivotal component that makes scars better in a reduction mammoplasty (a.k.a. [breast reduction](https://aedit.com/procedure/breast-reduction)) is the technique. As he explains, in a “classic, old-school” inferior pedicle breast reduction, flaps are raised and closed “under tension over the top of the pedicle.” With a superior or superior-medial pedicle, meanwhile, “no flaps are raised” and “the pillars are closed together so there’s minimal tension on the skin,” he shares.

<BeforeAfterModule
  title={Before & Afters: Breast Reduction}
  procedureId={801}
/>

### **Gynecomastia Surgery**
[Male breast reduction](https://aedit.com/procedure/male-breast-reduction), or gynecomastia surgery, is one of the most popular cosmetic procedures for men in the U.S. Like a female breast reduction, patients may need fat removal, skin excision, or a combination of the two depending on the grade of gynecomastia. Unlike female breast reduction, the majority of patients do not need significant incisions. “Most gynecomastia is done with liposuction through a small opening,” Dr. Frederick says. “This external scarring is typically not an issue.”

<BeforeAfterModule
  title={Before & Afters: Male Breast Reduction}
  procedureId={1022}
/>

## **Liposuction & Fat Transfer**
Speaking of liposuction, the gold standard of fat reduction tends to be minimally invasive as far as incisions are concerned. “Liposuction scars are small — approximately 3 millimeters — and placed in well-hidden areas of the body,” Dr. Mahmood explains. For example, in abdominal liposuction, incisions are usually made low in the bikini line and in the umbilical hood for concealment purposes. “Incisions are minimal and tend to heal well,” she says. It should be noted, however, that if you opt for a type of lipo that is heat-based (like [VASER](https://aedit.com/procedure/ultrasound-assisted-liposuction) or [Smartlipo](https://aedit.com/procedure/smartlipo)), “there is a higher risk of scarring at the liposuction cannula site,” Dr. Mahmood cautions.

<BeforeAfterModule
  title={Before & Afters: Liposuction}
  procedureId={1021}
/>

Depending on your aesthetic goals, the fat removed via liposuction may be purified and injected into another part of the face or body. Known as fat grafting or fat transfer, the combination procedure is the basis for the [Brazilian Butt Lift (BBL)](https://aedit.com/procedure/brazilian-butt-lift) and [breast augmentation with fat transfer](https://aedit.com/procedure/breast-augmentation-with-fat-transfer), in addition to serving as an alternative to synthetic filler when [contouring the face](https://aedit.com/procedure/facial-fat-grafting) and [rejuvenating the hands](https://aedit.com/procedure/hand-rejuvenation-with-fat-transfer).

As for injecting the fat from the donor site, Dr. Frederick uses an 18 gauge needle and “small pokes” so there are no external scars. “The important thing is to fan out the fat evenly and quickly because it swells almost instantaneously and that will distort the [treatment area] and prevent you from seeing where you injected the fat if you do it too slowly,” he shares.

## **Thigh Lift**
The purpose of a [thigh lift surgery](https://aedit.com/procedure/thigh-lift) is to remove excess skin and fat and reposition underlying tissue to lessen the appearance of sagging. According to Dr. Frederick, the incision “almost always” runs along the inside of the leg and the groin crease, which can be problematic for healing. “The problem with the groin crease scar is that it’s fighting gravity, as the weight of the leg pulls down on it,” he explains. There are steps a surgeon can take while operating to lessen the burden. Ultimately, “it’s important to anchor the thigh to the more sturdy aspects of the pelvis so that it doesn’t drop back down with gravity,” Dr. Frederick shares.

<BeforeAfterModule
  title={Before & Afters: Thigh Lift}
  procedureId={823}
/>

## **How to Care for Scars After Plastic Surgery**
As we’ve alluded throughout the article, [well-healed scars](https://aedit.com/aedition/minimizing-scars-after-surgery) start in the operating room. “As plastic surgeons, we are very familiar with scarring and various techniques to help minimize the visibility and size of scars,” Dr. Unger shares. “There are methods and materials we can use to help improve scar tone and texture and quality.” This includes specific closure techniques and sutures that yield a ‘tension free’ result. “We use multiple layers of stitches commonly and try to make sure there is no ‘pulling’ on the final incision line,” he explains. “Tension or stress across an incision is a major determinant in how wide or thick a scar may end up.”

Once you’re home, you too can work to keep tension to a minimum. “Significant tension on the scar either at the time of surgery or by the patient’s increased activity early in the post-op period, affects how the scar heals,” Dr. Mahmood cautions. [Compression garments](https://aedit.com/aedition/benefits-of-compression-garments-after-cosmetic-surgery) (worn in accordance with your surgeon’s post-op instructions) are one way to decrease [swelling](https://aedit.com/aedition/how-to-treat-minimize-swelling-after-cosmetic-surgery) and, in turn, minimize undo tension, as is being [mindful of your movement](https://aedit.com/aedition/when-to-start-exercising-again-after-cosmetic-surgery-procedures). “For example, stay hunched over after a tummy tuck,” Dr. Frederick notes. 

Topical treatments, like [silicone gels and strips](https://aedit.com/aedition/scar-minimizing-skincare-to-use-after-surgery), can be a helpful part of the recovery process — but consistency is key. “Silicone sheeting can help, but it’s like putting a tomato in a greenhouse,” Dr. Frederick says. “It needs to be there everyday for six months to get a 10 to 15 percent better yield.” 

It’s important to remember that scars can take a year or more to fully heal and fade. If you are unhappy about the appearance of your surgical scars, talk to your surgeon. As Dr. Unger shares, there are “a range of minimally invasive skin-remodeling techniques such as [dermabrasion](https://aedit.com/aedition/dermabrasion-might-be-the-scar-treatment-youve-been-looking-for) and lasers that can help place the body into optimal position for the best possible healing.”

In a perfect world, cosmetic surgery would be incision-free. We’re not quite there yet, but, in the hands of a skilled surgeon, scarring after body procedures can be minimal.

What Kind Of Scarring You Can Expect From Plastic Surgery On The Body

What Kind Of Scarring You Can Expect From Popular Body Procedures

shutterstock 421420426

If you’re thinking about undergoing a cosmetic procedure, you are probably wondering what you can realistically expect from the outcome. One aspect of the result that is easy to overlook is [scarring](https://aedit.com/aedition/minimizing-scars-after-surgery). Any time there is an incision, there will be a scar, but much can be done to conceal and/or minimize what it looks like. Choosing a highly skilled, board certified plastic surgeon will go a long way towards ensuring an optimal outcome, but it’s still helpful to have a sense of what you’re in for. 

To better understand what types of scars can result from facial surgeries — and the best ways to treat them — we’ve asked the experts.

## **Scarring After Facial Procedures**
The single most important factor in determining how your surgical incisions heal? The skill of your surgeon. “For the surgeon, the best way to minimize a scar is to have minimal to no tension on closure,” says [Steven Pearlman, MD](https://aedit.com/provider/steven-pearlman-md-420), a double board certified facial plastic and reconstructive surgeon and founder of Pearlman Aesthetic Surgery in New York City. “Skin should be undermined or advanced so it lies in a closed position and the sutures are just to line things up.” 

This is actually easier to accomplish on the face than on the body. “Fortunately, facial skin is under little tension, so, if closed properly, should show minimal scars,” he shares. “On the body, we are constantly moving and breathing, so scars can be pulled on and stretched during healing, no matter how well the incision is closed.”

The type of stitches used to close an incision also plays a role in the healing process. “Using buried absorbable sutures helps to reduce skin tension during healing,” Dr. Pearlman shares. As he explains, scars take six to 12 months to fully heal, but skin sutures need to be removed in a week or less — depending on the area of the face — to reduce the chance of the railroad-like tracks. 

With all of this in mind, below is a break down of the incisions required of some of the most popular facial procedures:

## **Facelift**
There are several types of rhytidectomy (a.k.a. facelift), each of which addresses specific concerns and areas of the face. As a result, each facelift technique has its own scar. For the sake of simplicity, we’ll break it down into mini and full facelifts.

<BeforeAfterModule
  title={Before & Afters: Facelift}
  procedureId={991}
/>

### **Mini-Facelift**
Starting with the least invasive, the so-called [mini-facelift](https://aedit.com/procedure/minifacelift) gets its name from the size of the incision involved. “The mini facelift is named ‘mini’ because of the ‘mini’ incision, which results in a ‘mini’ scar,” says [Oren Friedman, MD](https://aedit.com/provider/oren-friedman-md-1609), a double board certified facial plastic and reconstructive surgeon and director of facial plastic surgery at the University of Pennsylvania. Generally speaking, the incision is made at the temple and continues around the bottom of the ear. “It is a great surgical option for younger patients in their [thirties](https://aedit.com/aedition/best-cosmetic-procedures-plastic-surgery-to-consider-in-your-30s), [forties](https://aedit.com/aedition/best-cosmetic-procedures-plastic-surgery-to-consider-in-your-40s), and [early-fifties](https://aedit.com/aedition/best-cosmetic-procedures-plastic-surgery-to-consider-in-your-50s-60s-70s) who have ‘mini’ amounts of sagging in the face and neck and who want to achieve natural-looking facial rejuvenation,” he adds.

### **Traditional Facelift**
A traditional facelift (including [deep plane](https://aedit.com/procedure/deep-plane-facelift) and [SMAS](https://aedit.com/procedure/smas-facelift)) has the ability to address more of the face and underlying fat and musculature, which leads to larger incisions than their mini counterparts — but they can still yield natural-looking results. “The art of facelift surgery lies in the surgeon's ability to conceal the incisions and to create a natural, unoperated look,” Dr. Friedman explains. “Even the most dramatic facelift results can look natural and unoperated, and show nearly invisible scars.” 

The incision “begins in the crease in front of the ear, goes behind the rectangular cartilage (called the tragus), and then around the ear in the crease behind,” Dr. Pearlman says. “Above the ear and in the hairline behind the ear, the incision is made right at the edge of the hairline so the hair will grow right through the incision making it difficult to see.”

How natural it looks once it’s healed comes down to the skill of the surgeon. “Strategic placement of the incisions in areas that are hidden from view, lifting the tissues in natural vectors, and closing the incisions with meticulous technique allow for optimal scar camouflage and optimal results,” Dr. Friedman explains.

While Dr. Pearlman says that the incisions “are difficult to see if closed without tension,” patients with darker or [thicker skin](https://aedit.com/aedition/facelifts-for-men) should take extra precautions. “You can use a silicone-based gel twice a day for a few months to minimize scar visibility,” he shares. “When closed properly, a facelift scar should not be visible unless someone is looking very closely or knows exactly what to look for.”

## **Brow Lift** 
[Chemical (a.k.a. Botox) brow lifts](https://aedit.com/procedure/chemical-brow-lift) have become a popular way to address the eyebrow area in a minimally invasive way. But, when neuromodulator injections no longer do the trick, surgery is the next step. As with facelifts, there are tiers to the invasiveness of a brow lift.

<BeforeAfterModule
  title={Before & Afters: Brow Lift}
  procedureId={980}
/>

### **Coronal Brow Lift**
In a [coronal brow lift](https://aedit.com/procedure/coronal-brow-lift), an incision is made across the scalp just behind the hairline. That may sound quite conspicuous, but you’d be surprised to know that it doesn’t have to be. “The incision can be made in a very special way that allows hair to grow directly through the incision line, enabling the scar to be nearly invisible,” Dr. Friedman says.

### **Endoscopic Brow Lift**
The large majority of surgical brow lift patients undergo an [endoscopic brow lift](https://aedit.com/procedure/endoscopic-brow-lift). It’s less invasive than the coronal technique, though it requires multiple points of entry. “The endoscopic brow lift is performed with four or five very small one-centimeter incisions that sit behind the hairline,” he explains. “In this way, the endoscopic brow lift is a minimally invasive way to raise the eyebrows, resulting in the smallest possible external scars.”

## **Blepharoplasty**
When it comes to rejuvenating the eye area, there are two main categories of blepharoplasty surgery: upper eyelid and lower eyelid. Depending on the anatomy and aesthetic goals of the patient, they can be performed individually or combined. 

<BeforeAfterModule
  title={Before & Afters: Blepharoplasty}
  procedureId={981}
/>

### **Upper Eyelid Blepharoplasty**
An [upper eyelid blepharoplasty](https://aedit.com/procedure/upper-eyelid-blepharoplasty) (a.k.a. eyelid lift) can be performed for aesthetic or functional purposes. It removes excess skin and fat, which can improve vision in addition to rejuvenating the upper face. “The incision for upper eyelid blepharoplasty lies within the upper eyelid crease, which allows the scar to be nearly invisible,” Dr. Friedman says. “After surgery, when the patient opens their eyes, the incisional scar lies within the naturally occurring crease of the upper eyelid, which makes the scar very difficult to see.” The suturing technique also plays a role in why the scarring is imperceptible. “Suturing the scar from the deep surface of the skin and avoiding any skin sutures whatsoever allows for optimal scar camouflage and minimal scar visibility,” he adds. 

### **Lower Eyelid Blepharoplasty**
There are different types of lower eyelid blepharoplasty that can address sagging skin, displaced fat, or a combination of the two. A [lower eyelid transconjunctival blepharoplasty](https://aedit.com/procedure/lower-eyelid-blepharoplasty-transconjunctival-approach), for example, targets bulging fat bags under the eyes. “[It] may be safely performed from the inside of the lower eyelid, without any external incisions or resulting scars,” Dr. Friedman says. “The sagging fat from the eyelid can be removed with no skin incision at all and, therefore, with no scar at all.” 

The [subciliary approach](https://aedit.com/procedure/lower-eyelid-blepharoplasty-subciliary-approach), meanwhile, requires an incision just below the lash line of the lower eyelid. It allows for skin excision, smoothing of the preseptal musculature, alteration of orbital fat tissue, and repositioning of the support structures in the lower eyelid. 

## **Rhinoplasty**
There are two types of rhinoplasty: open and closed (or intranasal). “For [closed rhinoplasty](https://aedit.com/procedure/closed-rhinoplasty), the incisions are all hidden inside the nose,” Dr. Pearlman says. In the case of [open rhinoplasty](https://aedit.com/procedure/open-rhinoplasty), “the incision is on the bottom of the nose across the columella,” he explains. Even so, it’s quite discreet regardless of skin tone. “This incision is barely, if at all, visible in most patients,” Dr. Pearlman shares. “I tell patients that someone has to be close enough to be counting your nasal hairs and looking very closely, practically with a magnifying glass, to see it.”

<BeforeAfterModule
  title={Before & Afters: Rhinoplasty}
  procedureId={1004}
/>

## **Buccal Fat Removal** 
Chrissy Teigen made headlines earlier this year for undergoing [buccal fat removal](https://aedit.com/procedure/buccal-fat-removal) (a.k.a. cheek reduction) surgery, a surgical procedure that removes the buccal fat pads from the cheeks to slim and contour the mid-face without any visible scarring. “Buccal fat removal is performed from inside the mouth,” Dr. Pearlman shares. “The lining of the mouth, called the mucosa, heals very well from any incisions.”

<BeforeAfterModule
  title={Before & Afters: Buccal Fat Removal}
  procedureId={894}
/>

## **Facial Implants** 
We talk a lot about using [dermal filler to contour](https://aedit.com/aedition/how-to-reshape-your-face-with-filler-botox-injectables) the face, but patients looking for a permanent solution may be candidates for facial implants. Most commonly, they are added to the cheeks, chin, and/or jawline. As Dr. Pearlman explains, [cheek implants](https://aedit.com/procedure/cheek-augmentation-with-implant) and [jaw implants](https://aedit.com/procedure/jaw-implant) are placed from inside the mouth, and the incisions “heal very well.” [Chin implants](https://aedit.com/procedure/alloplastic-chin-implant), meanwhile, are placed via an incision in the crease under the chin. “People rarely look under the chin for scars,” he notes. “I also tell patients that many people have scars under there from falls as a child.”

## **Lip Lift**
[Lip lift](https://aedit.com/procedure/subnasal-bull-horn-lip-lift) before and afters have become ubiquitous on social media, and the procedure itself has undergone a transformation over the years. In the past, Dr. Pearlman says that the incision was placed “at the bottom of the nose,” which didn’t lend itself to optimal healing. Instead, “it should be at the shadow, or a slight inflection of the skin between the base of the nose and the upper lip,” he explains.

<BeforeAfterModule
  title={Before & Afters: Lip Lift}
  procedureId={926}
/>

While a “properly performed lip lift incision heals well,” Dr. Pearlman says there are additional steps that can be taken to further camouflage the appearance of the scar. “We offer fractionated laser resurfacing to all our lip lift patients at one month after surgery to minimize the scar,” he shares, adding that performing [resurfacing treatments](https://aedit.com/aedition/dermabrasion-might-be-the-scar-treatment-youve-been-looking-for) — like lasers or dermabrasion — on a fresh scar improves recovery. “The collagen is disrupted as it grows across the incision, so it lines up better during subsequent healing,” Dr. Pearlman adds.

## **Neck Lift**
Neck lifts are often [performed in tandem](https://aedit.com/aedition/pairing-facelift-neck-lift-procedures) with facelifts. “Most patients who come in for a neck lift also want the jowls reduced and the jawline made more youthful,” Dr. Pearlman explains. “That would now make it more cheek-neck lift, which is another phrase for a facelift.” 

<BeforeAfterModule
  title={Before & Afters: Neck Lift}
  procedureId={1002}
/>

With that said, we’d be remiss not to include the incisions a [neck lift](https://aedit.com/procedure/neck-and-jawline-definition-solutions) requires. “The incisions for a neck lift are under the chin and another around the earlobe and on the back of the ear,” he says. “Sometimes we extend this to the hairline behind the ear.” A neck lift can address “fullness under the chin, under the jawline and in the neck,” Dr. Pearlman adds. 

## **How to Care for Scars After Plastic Surgery**
Even though a lot of the onus for well-healing incisions is on providers, at-home care plays an important role in the recovery process. “To further minimize scarring, using a [silicone-based gel](https://aedit.com/aedition/scar-minimizing-skincare-to-use-after-surgery) twice a day for a few months will help keep pressure and reduce tension on the scar to improve healing,” Dr. Pearlman shares.

We would like to think you are already wearing [sunscreen](https://aedit.com/aedition/dermatologist-approved-sunscreen-for-face-body) on your face every day, but we’ll go ahead and reiterate that now is not the time to skimp on sun protection. Scars are more sensitive to sunlight than healthy skin and can easily darken or discolor. Keeping scars covered is your best bet, but, when that’s not an option, using a broad spectrum sunscreen with a minimum of SPF 30 (and reapplying every two hours) is a must.

Remember that scars can take a year or more to fully heal and fade. But, if you are unhappy with how yours looks, talk to your surgeon. Depending on what point you are at in the healing process, there are [professional treatments and procedures](https://aedit.com/aedition/how-to-treat-every-type-of-scar) that may be able to further minimize the appearance of post-surgical scars.


In a perfect world, cosmetic surgery would be incision-free. We’re not quite there yet, but, in the hands of a skilled surgeon, scarring after facial procedures can be minimal.

What Kind Of Scarring You Can Expect From Facial Plastic Surgery 

What Kind Of Scarring You Can Expect From Popular Facial Procedures

shutterstock 1935178430

If ever a miracle injectable existed, it may just be the [family of neuromodulators](https://aedit.com/aedition/comparing-neurotoxin-botulinum-type-a-injections-botox-dysport-jeuveau-xeomin). Best known by their brand names — [Botox®](https://aedit.com/procedure/botox), [Dysport®](https://aedit.com/procedure/dysportr), [Jeuveau®](https://aedit.com/procedure/jeuveau), and [Xeomin®](https://aedit.com/procedure/xeomin) — botulinum toxin type A injections are most celebrated and widely used as effective wrinkle reducers, but new findings point to yet another benefit. 

If you are planning to go under the knife for a cosmetic surgery, don’t be surprised if your surgeon brings up Botox® and the like as both a preventative and corrective step for [scar care](https://aedit.com/aedition/minimizing-scars-after-surgery). Here’s what you need to know about the benefits of Botox® for minimizing the appearance of scars.

## **What the Science Says**
Scientific data is the pinnacle of measuring the capabilities of a drug (cosmetic or not). Current research on neuromodulators to improve the look of scars is looking up. The use of neuromodulators for alleviating scars first became talk when a [2018 study](https://pubmed.ncbi.nlm.nih.gov/29481395/) tested the effects. “The results showed that the scars that received Botox injections were rated higher on their appearance than those that did not receive injections," says [Marina Peredo, MD](https://www.skinfluencenyc.com/), a board certified dermatologist in New York City. 

The [report](https://journals.lww.com/plasreconsurg/Fulltext/2018/03000/Effects_of_Botulinum_Toxin_on_Improving_Facial.14.aspx) in *Plastic and Reconstructive Surgery* detailed the benefits for patients who received treatment for four months, specifically after reconstructive surgery of the face (a procedure that often results in a bevy of distinct scars). The clinical trial showed that when these patients were treated with Botox early on, the injections produced narrower, better, and flatter surgical [scars](https://aedit.com/concern/scars). However, common scar characteristics such as color and vascularity were not notably different.

## **How Does Botox Minimize Scarring?** 
Let's take it back to the basics for a moment. Surgical sutures are the option of choice when a scar or laceration requires closure. When it comes to stitches, however, it is known that tension and movement around the edges of the scar lead to less optimal scarring, says [Jonathan Cabin, MD](https://aedit.com/provider/jonathan-cabin-md-956), a double board certified facial plastic and reconstructive surgeon in Arlington, VA. 

Plastic surgeons have long known that certain types of facial scars naturally heal better than others. One reason is the scar's direction, and how it’s positioned compared to the underlying muscles, says Esther Yoonah Kim, MD, a board certified plastic and reconstructive surgeon and co-founder of [Advanced Institute for Plastic Surgery](https://www.aiplasticsurgery.com/) and [Bloom Spa](https://www.bloomspa.com/) in Temecula, CA. “If the scar lies against the pulling muscles, there is a tug-of-war across the scar,” she explains. “This tension will pull the scar apart, leading to a widened, thicker, and uglier scar.”

We know that Botox® (and other neuromodulators) temporarily reduce muscle movement to limit wrinkle formation. Dr. Cabin explains that this same theory works to help reduce the tension and movement around healing wounds, thus reducing the forces that can worsen scarring. While neuromodulators won’t totally stop the muscles from ripping at a scar, they will help create less stress and allow the scar to heal properly. 

When repetitive tensile forces in any direction by muscles under or around wound edges or tissue might negatively affect the overall healing processes, botulinum toxin injections can have an impact, says [Ava Shamban, MD](https://aedit.com/provider/ava-shamban-md-2325), a board certified dermatologist in Santa Monica, CA. “Wound healing is a complex range of processes from homeostasis to inflammatory response and the dermal cell remodeling,” she explains. “Interruptions to these processes can lead to disruption and complications, such as derailing fibroblast activity or prolonging the inflammatory response, and delays in healing can result in scar hypertrophy or increased pigmentation.”

To make the most of the treatment, your surgeon should inject the to-be-operated-on area *before* the procedure to limit the mobility of the muscles in the region. “If I am planning to make an incision in an area, like the forehead, where Botox® can safely reduce movement, I always inject Botox® (or an equivalent toxin) two weeks before the planned procedure, since it takes that long for toxins to kick in,” Dr. Cabin shares. 

This approach creates an ideal situation where most movement in that specific area is significantly reduced right at the onset of the recovery process, but the injections can also occur post-op. “The treatment works best when injected early in healing — preferably before creating a scar — but within the first few months when the wound is going through its initial healing process and is most sensitive to tension and movement," he adds. This way, the resulting scar will heal thinner and flatter.

## **Not All Scars Are Equal**
Using neuromodulators to improve scars falls under the bucket of off-label (read: not approved by the United States Food and Drug Administration yet relatively safe and well-documented) [neurotoxin uses](https://aedit.com/aedition/where-to-use-botox-from-head-to-toe). But unlike many of Botox® and friends’ non-FDA-approved benefits, scar improvement is one treatment that provides significant physical *and* emotional benefits. Scars come with memories, some of which can be debilitating or a sign of a remembered trauma.

While all neuromodulators will theoretically have the same effect on the scar, [Jennifer Levine, MD](https://www.drjenniferlevine.com/), a double board certified facial plastic and reconstructive surgeon in New York City, says some patients and providers prefer Xeomin® in this case. "Xeomin® is often embraced because it is a [cleaner alternative](https://aedit.com/aedition/clean-injectable-filler-neurotoxin-trend) to other neuromodulators," she says. Unlike Botox®, Dysport®, Jeuveau®, it is a pure form of botulinum toxin formulated without stabilizing proteins.

Treating older scars with Botox probably won't produce the same result, but, like everything in life, there are exceptions to the rule. In some instances, scars that are mature and more than one year old may respond positively. “It really depends on the orientation of the scar,” Dr. Cabin says. “Reduction of expression through the use of Botox can temporarily reduce the repeated reinforcement of the scar and minimize its noticeability, especially in the forehead or central brow.” But, in these cases, improvements in the appearance of the said scar are more temporary in nature. Repeat treatments every few months are required.

Neuromodulators aren't compatible with [every type of scar](https://aedit.com/aedition/how-to-treat-every-type-of-scar). Even if they are new and fresh, keloid scars won’t respond positively. They need to be treated with a laser or corticosteroids. When used directly on the scar, a [corticosteroid solution](https://aedit.com/procedure/intralesional-steroid-injection) may help improve the texture and tone of the skin where an existing mark exists due to a cut or abrasion. Furthermore, Dr. Shamban says corticosteroids may help reduce the scar's height, density, and overall size since steroids break the woven bonds between collagen fibers, thus reducing the amount of scar tissue beneath the skin.

Neurotoxins, meanwhile, works best on certain new scars, such as skin cancer removal, [Mohs surgery](https://aedit.com/procedure/mohs-surgery), and reconstructive surgery, though timing is everything. In some cases, a neuromodulator alone isn’t enough to make a dramatic improvement in the appearance of the scar and additional treatments may be needed. "Some people use a combination of Botox, lasers, and [skincare](https://aedit.com/aedition/scar-minimizing-skincare-to-use-after-surgery) to get the skin in optimal condition," Dr. Peredo explains. She also stresses that using good skincare before surgery is vital to encourage better healing. “Keeping the body hydrated and reducing caffeine and alcohol intake can help with wound healing,” she says.

## **How Long Botox Lasts**
If you get Botox® and co. for wrinkles, you are accustomed to [routine maintenance](https://aedit.com/aedition/how-frequently-to-get-non-surgical-cosmetic-procedures-like-dermal-filler-botox-chemical-peel) sessions every three to four months. When it comes to treating fresh scars, however, Dr. Cabin says that only one appointment is needed because the treatment lasts about two to four months. “This provides a large window of activity, during which the initial phase of healing will occur,” he explains. After this period, neuromodulators are less critical. 

Follow-up sessions every two to four months for the first year can be beneficial for some patients, but they’re not always necessary. “It’s about minimizing movement around the healing wound during a window of time when the scar is forming, reducing the final scar,” Dr. Cabin says. When done correctly, one initial treatment can have a lifetime impact on the outcome. 

Is there anything neuromodulators can’t do?

Botox Injections To Minimize The Appearance Of Plastic Surgery Scars

How To Use Botox To Minimize Post-Surgery Scarring

nsey-benajah-P-0xj CW86Y-unsplash

No matter their origins, [scars](https://aedit.com/concern/scars) are often fraught with meaning. For some, they’re a sign of victory: the mark of survivorhood. For others, they’re a reminder of a chapter they’d prefer to close. Regardless, there remains the fact that, for a multitude of reasons, some scars heal better than others. 

When it comes to [mastectomy](https://aedit.com/aedition/what-to-expect-before-during-after-mastectomy-breast-cancer) and [breast reconstruction](https://aedit.com/aedition/comprehensive-guide-to-breast-reconstruction-nipple-reconstruction-after-breast-cancer), for example, how well your scar blends into your surrounding skin over time depends on your surgeon’s skill and your unique physiology. Proper aftercare, along with [topical scar therapies](https://aedit.com/aedition/scar-minimizing-skincare-to-use-after-surgery) (think: silicone gel or strips) and [cosmetic procedures](https://aedit.com/aedition/how-to-treat-every-type-of-scar) (like microneedling and lasers) can make a noticable difference.

In recent years, a newer scar-minimizing treatment has been gaining popularity. It’s called scar camouflage, and it uses techniques similar to [permanent makeup](https://aedit.com/aedition/permanent-makeup-after-chemotherapy-cancer) (a.k.a. cosmetic tattooing) to, well, camouflage the appearance of the mark. Here’s what you need to know about the trend.

## **What Is Scar Camouflage?**
Also known as skin color tattooing or camouflage tattooing, scar camouflage is a needle and pigment technique that blends scars into the surrounding natural skin using permanent makeup pigments. Typically performed by a medical or paramedical tattoo technician/artist, skin repigmentation has become increasingly popular for its ability to improve the appearance of scars, [stretch marks](https://aedit.com/concern/stretch-marks), and other areas affected by hypopigmentation (read: missing color).

Just like other forms of paramedical tattooing, scar camouflage isn’t the same as a typical decorative tattoo. Let’s review what makes cosmetic tattooing different from traditional tattoo techniques:

### **Traditional tattoos**
- Considered a ‘cosmetic’ by the FDA (meaning they’re not regulated)
- Ink (black and bright colors) derived from a variety of chemicals, including metals
- Injected deeper into the dermis
- Cannot be broken down by the body (i.e. they’re permanent)
- May fade slightly and/or become fuzzy over time

### **Cosmetic tattoos**
- Considered a ‘cosmetic’ by the FDA (meaning they’re not regulated)
- Micropigments (neutral skin tones adjusted with white) made primarily from titanium dioxide, as well as organic and inorganic substances
- Injected more superficially into the dermis
- Partially broken down and faded by the body (i.e. they’re semi-permanent)
- Likely to fade completely over time

## **What Type of Scars Can Be Camouflaged?**
When evaluating a scar for corrective micropigmentation, the source of the scar is not as important as its look and feel. Once fully healed, any type of pigment loss is generally amenable to micropigment color correction, including:

- Scars (from surgery or injury)
- Stretch marks
- Areas lacking pigmentation (from skin conditions like [vitiligo](https://aedit.com/aedition/guide-to-vitiligo-causes-treatments))

“Any type of surgery scar can be camouflaged, what matters most is how the scar healed,” says [Nicole Johnston](https://www.instagram.com/nicolejohnstontattoo/?hl=en), a cosmetic and restorative tattoo artist at [Studio Sashiko](https://studiosashiko.com/) in British Columbia, Canada. Typically, technicians recommend waiting until the scar is, at a minimum, one year old before opting for scar camouflage. “Scars cannot be worked on shortly after surgery,” Johnston explains. “A scar will go through many stages of healing and will change in appearance over time,” she notes. As such, Johnston typically asks clients to allow their scar to heal for at least two years before visiting her. 

Whether or not a particular scar can be repigmented depends on both the artist’s skill and the nature of the scar. The most ideal scars and stretch marks are those that are flat (or nearly flat) and paler than the surrounding tissue. “Most scars can be camouflaged,” Johnston shares. “But there are times when we won’t see ideal results.” She lists several characteristics that will likely impede a technician’s ability to successfully camouflage a scar:

- Keloid or highly textured
- Hyperpigmentation 
- Thinned, translucent skin

## **How to Prepare for a Scar Camouflage Treatment**
If you think skin color correction may be the solution for your scar, there are a few things you need to know beforehand:

### **1. Do Your Homework**
When considering corrective pigment camouflage, finding a skilled and qualified medical or paramedical tattoo artist is extremely important. Although some states are stricter than others, the United States Food and Drug Administration (FDA) considers scar camouflage to be a subset of permanent cosmetics and does not impose much regulation.

Here’s what you need to look for when searching for a provider:

- **Training & Certification**: A one-day training session isn’t going to make a technician an expert. Look into your local municipality’s laws around credentials and be sure to research how long the provider has been practicing and what certifications they’ve acquired.
- **Experience & Knowledge**: As mentioned above, a certain level of expertise can only come from years on the job, and you'll also want to be treated by someone who has experience working with clients with similar features or concerns to your own.
- **Facility**: Check to make sure the salon or office the technician works at is clean and appears to be following local standards.
- **Photos**: Standardized before and after pictures will give you a good idea of the caliber of the work. Check out our [guide to viewing B&As](https://aedit.com/aedition/importance-of-before-and-after-photos-in-plastic-surgery) to learn more about what to look for.
- **Happy Clients**: A skilled and reputable artist will never shy away from allowing past clients to share their experience with you, so don’t be afraid to ask.

According to Johnston, “experience and honesty” are two of the most important qualities to look for in a skin camouflage professional. “Scars are complicated and every situation is different,” she explains. “If an artist gives you an immediate ‘yes’ without indications of what to expect with your results, you may want to keep researching.” As it relates to honesty: “I regularly turn away clients if I know I cannot make worthwhile improvements,” she adds.

### **2. Expect a Consultation**
During your consultation, your tattoo artist will evaluate your particular scar and ask many questions — particularly about your medical history — in order to gain a better understanding of your body chemistry. This includes questions about:

- Medications (including vitamins and supplements)
- Any traditional, medical, or cosmetic tattoo history
- Skin type
- Allergies
- Autoimmune conditions
- Scar tendencies
- Ability to schedule follow-up treatments

### **3. Be Prepared to Prep**
Based on the appearance of your scar, your medical tattoo artist may suggest any number of pre-treatments. “Often, I will recommend a client get laser or microneedling done on a scar prior to coming to me so that we can see the best results,” Johnston says. “[Laser](https://aedit.com/procedure/nonablative-fractional-lasers) and [microneedling](https://aedit.com/procedure/microneedling) will help flatten the scar and improve its texture.” Another benefit of lasers, she adds, is that they can also lighten [hyperpigmentation](https://aedit.com/concern/uneven-skin-tone). “By doing this first, the client can see a much better result than if I were to only work on the color of the scar,” Johnston shares.

### **4. Consider Cost**
The price of a skin repigmentation varies by geographic location and the experience level of your tattoo professional. Expect to pay anywhere from several hundred dollars for work on a very small scar to several thousand for larger, more complex scar work performed by an in-demand artist. Typically, scar camouflage is not [covered by insurance](https://aedit.com/aedition/insurance-coverage-for-plastic-surgery-cosmetic-procedures) — unlike other types of medical tattooing, like [reconstructive nipple and areola](https://aedit.com/aedition/reconstructive-nipple-tattoos-for-breast-cancer-survivors-dominique-bossavy), for which some insurance companies do reimburse patients (at least partially).

## **What to Expect After a Scar Camouflage Treatment**
“I always tell my clients that they shouldn’t expect to see immediate results,” Johnston says. The reason for this is because the tattoo needs to continue to be perfected. “In order for the results to look the most natural, I am conservative with the amount of color I add in one session to the scar,” she shares. “My focus is for the result to look like skin and not like I’ve applied makeup to the area.” As a result, “clients will see full results after their touch up session,” Johnston notes — and she offers additional touch ups as needed. 

As with any healing process, it’s important to remember that the recovery from scar camouflage is an evolution. “A phrase I use with my clients is, ‘everything looks worse before it looks better,’” she says. “Scars and stretch marks are more fragile than the surrounding skin, therefore they tend to respond with a bit more redness or swelling when being worked over.” These side effects usually subside within a couple days, Johnston explains, but, for some individuals, the residual redness can last a few weeks.

### **What Are the Risks of Scar Camouflage Tattooing?**
Just like a conventional tattoo, corrective cosmetic tattooing carries certain risks. Choosing a well-qualified provider will minimize your chances of complications, which include:

- Infection
- Allergic reaction
- Granulomas 
- Poor color match
- Fading
- Discoloration

Sticking to the recommended after-care regimen is also extremely important, as your tattoo is essentially an open, healing wound for two to four weeks

## **Is Scar Camouflage Reversible?**
[Laser tattoo removal](https://aedit.com/procedure/laser-tattoo-removal) has come a long way in recent years. When it comes to skin repigmentation tattoos, however, trying to reverse the process isn’t as straightforward as it seems. Lasers target the color molecules and break them apart to be excreted by the body, but they can’t be used on titanium dioxide (a white pigment very often used to match lighter skin tones). Lasers turn this white metal gray, leaving an even more conspicuous mark.

Although there are alternative options for removing permanent makeup pigments, scar tissue doesn’t behave the same way healthy skin does. All of these factors make it much more difficult to alter a cosmetic tattoo than a decorative one or even [microblading](https://aedit.com/aedition/microblading-treatments-for-fuller-thicker-eyebrows).

## **The Takeaway**
A well-executed scar camouflage tattoo can be life-changing for clients — improving self-esteem and helping them move on. “This procedure can have incredible effects on a patient’s quality of life,” Johnston notes. As she explains, scars are often associated with difficult memories. “For our breast cancer survivors, it can help them feel like themselves again and recognize what they see in the mirror,” she shares. “We also help clients cover the scars from their abusers or from self-harm done in the past.” In many cases, scar camouflage represents a fresh start. “It’s a way for them to move on,” Johnston says, “and not see the reminder every day.”

Using techniques similar to permanent makeup, scar camouflage tattoos can, well, camouflage the appearance of scarring, stretch marks, and more. Here’s what you need to know.

Scar Camouflage Tattooing: Benefits, Treatment, Cost, Results

Everything You Need To Know About Scar Camouflage Tattooing

shutterstock 1377590150

All scars form for the same reason — a [surgery](https://aedit.com/aedition/minimizing-scars-after-surgery), [burn](https://aedit.com/aedition/how-to-treat-first-second-third-degree-burns), cut, [acne spot](https://aedit.com/concern/acne-scars), or trauma of some sort occurs, which signals a dermal healing response that recruits inflammatory cells. “Living animals all have a natural ability to attempt restoration of function and repair damage to the body after an injury.” explains [James Beckman, MD](https://aedit.com/provider/james-beckman-md-34641), a board certified plastic and reconstructive surgeon and founder of [Therapon Skin Health](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Ftheraderm.net%2F). “Whether it is skin, other tissue, or even entire organs, scar formation is the first step.” The purpose? “It serves to cover open areas, preventing bacteria from entering and keeping tissues from drying out,” he says.

When you consider the state our bodies would be left in without the ability to scar, it’s a pretty remarkable phenomena. “If our skin would not scar, we would be walking around with big open wounds, which is why scarring is a necessity,” says [Gregory Buford, MD](https://aedit.com/provider/gregory-buford-md-1015), a board certified plastic and reconstructive surgeon in Englewood, CO. “It’s just that society has determined that it’s not pretty.” He likens scars to a kind of biological glue. 

With that said, there is no rhyme or reason to how the body responds to injury, which means you can be left with some pretty [unique scars](https://aedit.com/concern/scars). If you are unhappy with the appearance of a scar — no matter where it came from — there are ways to minimize it. Read on for both at-home and in-office [scar solutions](https://aedit.com/procedure/scar-solutions).

## **What Determines the Appearance of a Scar**
Even on the same person, no two scars heal the same. As [Jessica Weiser, MD](https://aedit.com/provider/jessica-weiser-md-34640), a board certified dermatologist in New York City, explains, there are several reasons why scars settle uniquely, including: 

- Extent of the injury
- Location of the wound
- Genetics
- Body’s collagen response (i.e. how much of the protein, which is like the building block of skin, is made)

“When new collagen forms, the bundles fill in a wound in the dermis (the second layer of skin),” she says. When just the right amount of collagen is produced, the scar is flat; too much collagen leads to thick, rope-like raised scars and keloids. All scars start red and, as they mature, transform to pink and then white. 

Like a good piece of real estate, the end result is all about location, location, location — certain parts of the body are better equipped to handle the formation of a scar than others. “Luckily, on the face, there is a good blood supply, so the area tends to heal more readily there,” says [Amanda Doyle, MD](https://aedit.com/provider/amanda-doyle-md-31526), a board certified dermatologist at Russak Dermatology Clinic in New York City. The same cannot be said the further south you go. “As you get towards the waist and further down, the blood supply is farther from the heart, so it takes a lot longer to heal because of the location,” she shares. 

Another factor that affects scarring is tension. “In areas like the shoulder or the back, there is a lot of pulling and tugging, and that can lead to a wider-looking scar because of constant tension in that location,” Dr. Doyle adds.

## **Types of Scars**
Scars are like snowflakes — no two are identical. At the most macro level, scars can be classified into two categories:

1. **Sunken (a.k.a. atrophic)**: “Sometimes, there is an absence of fat or other underlying structures that the body cannot fill in and scars end up atrophic or indented,” Dr. Doyle explains. 
2. **Raised (a.k.a. hypertrophic)**: “In other circumstances, the body stimulates an overly exuberant response that causes excess scar tissue clinically appearing as raised or keloid-type scars, which are typically the most challenging ones to treat,” she says. “Even with treatment, they may recur or may not respond as readily.” 

Moving to a more micro level, there are specific types of scars within those initial classifications:

### **Atrophic Scars**
- **Ice Pick Scars**: Deep and narrow but small, ice pick scars almost always have a tie to [nodular or cystic acne](https://aedit.com/concern/acne). Resembling a puncture wound of sorts, ice pick scars are commonly categorized as indented skin and occur on the cheeks.
- **Boxcar Scars**: Rounder in shape and resembling more of a crater, boxcar scars are wider than an ice pick scar but not as wide as rolling scars. They are often due to acne, and the deeper they are, the harder they are to treat. 
- **Rolling Scars**: Reminiscent of a pit but with undefined edges, the more common rolling scars give the area an almost wavy texture and can worsen with age due to a loss of elasticity and collagen in the skin. 

### **Hypertrophic Scars**
While not all hypertrophic scars are keloid scars, keloids are perhaps the best known raised scars. They are also considered among the most difficult to treat. Keloids tend to be wide, large, and puffy and occur after a surgery, cut or wound, or even piercing. As Dr. Buford explains, keloids grow outside of the boundaries of the scar and are technically tumors (tumors, by definition, are a growth in the skin and can be noncancerous). 

Keloids tend to be more common in people with darker skin (but any [skin tone](https://aedit.com/aedition/guide-to-fitzpatrick-skin-types) can develop them). “Although keloid scarring generally tends to happen in Asians and African Americans, we don’t fully know why it affects certain skin tones,” Dr. Doyle says. “It’s related to the whole inflammatory process and collagen being re-formed in those areas of injury.” For whatever reason, some people experience that inflammatory response a little more robustly than others, and, “particularly in those two populations, we see it more frequently,” she adds.

## **At-Home & In-Office Scar Treatments**
Scars don’t subscribe to a one-treatment-fixes-all method. Each class of scar responds differently to treatment, which is why picking the right procedure is important. To get the best result, Dr. Doyle recommends an in-person evaluation so your doctor can fully evaluate the size, color, and texture of the scar. Most scars can show improvement, even if that means taking a mix-and-match approach. “There’s no silver bullet or monotherapy that makes scars look perfect,” Dr. Buford cautions. “We can’t always remove a scar in its entirety, but we can take the red out, modulate the scar, and make it thinner.” 

Whether your scar is fresh or more mature, the [first rule of scar care](https://aedit.com/aedition/scar-minimizing-skincare-to-use-after-surgery) is to make sure to always protect it from the sun with [sunscreen](https://aedit.com/aedition/best-sunscreens-of-2021) to prevent discoloration and improve its appearance. From there, below are the most effective treatment options for each scar type:

### **1. Topical Scar Gels** 
- **Best For:** Scars that are less than six months old
- **The 411:** If a scar is newer, faint, and pretty small, you may be able to treat it with a cocktail of over-the-counter topical ingredients like [vitamin C](https://aedit.com/aedition/guide-to-topical-vitamin-c-in-skincare), [retinol](https://aedit.com/aedition/guide-to-vitamin-a-retinol-retinoids-in-skincare), and hydroquinone or a specifically formulated [scar cream](https://aedit.com/aedition/scar-minimizing-skincare-to-use-after-surgery), which contains a cocktail of effective ingredients.
- **Find It In:** [Avène Cicalfate+ Scar Gel](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.dermstore.com%2Fproduct_Cicalfate%2BScar%2BGel_85402.htm) & [Visha Skincare Advanced Correcting Serum](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.vishaskincare.com%2Fproducts%2Fadvanced-correcting-serum-with-illuminotex)

### **2. Silicone Gel Sheets** 
- **Best For:** Minimizing closed, raised surgical scars
- **The 411:** These specially designed self-adhesive sheets (they’re somewhat reminiscent of a mega bandage) work well for pretty much all types of scars. Not only do they act as an occlusive dressing (read: seals in moisture by creating a barrier), but they also regulate pressure on the scar. Dr. Beckman says that silicone gel sheets have an unexplained effect to keep both the scar and skin surfaces from becoming raised, unsightly, or painful.
- **Find It In:** [Embrace Scar Sheets](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.embracescartherapy.com%2Fshop-by-product) & [Aroamas Professional Silicone Scar Sheets](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.walmart.com%2Fip%2FAroamas-Professional-Silicone-Scar-Sheets-Soften-Flattens-Scars-Resulting-Surgery-Injury-Burns-Acne-C-section-more-Soft-Strips-3-1-57-8-Sheets-4-Mont%2F696436019)

### **3. Polyurethane Dressing**
- **Best For:** Hard, red, & raised scars
- **The 411:** A flexible, waterproof pad of sorts, “polyurethane dressings, while initially used for wound healing, have been shown in a [few smaller studies](https://pubmed.ncbi.nlm.nih.gov/19440173/) to positively impact the scar surface, improve the microcirculation and improve scar color, firmness, and thickness,” Dr. Weiser says. As she explains, polyurethane is “an alternate ingredient to silicone but behaves in the same way as an occlusive dressing.”

### **4. Steroid Injections**
- **Best For:** Keloids & thick, raised, itchy, or painful scars that are fully healed 
- **The 411:** Performed by your dermatologist or plastic surgeon, steroid injections use cortisone to take down scar thickness. Some even contain very small amounts of 5-fluorouracil (5-FU), a cancer drug that reduces fibroblast activity and, in turn, hinders the progression of scar tissue. There is the potential for the injection site to darken, but, when cortisone is injected into a keloid, Dr. Beckman says that the steroid softens and weakens the scar.

### **5. Hyaluronic Acid & Biostimulatory Fillers**
- **Best For:** Sunken & indented scars, like ice pick acne scars
- **The 411:** For the past few years, doctors have been [injecting fillers](https://aedit.com/procedure/acne-scar-treatment-dermal-fillers) like Juvéderm® and Belotero® Balance to treat scars. “Dermal fillers help add volume to level a sunken scar with the surrounding tissue,” Dr. Weiser says. Depending on the patient’s preference, “hyaluronic acid fillers can be used for immediate improvement or biostimulatory fillers can be used to stimulate collagen production around the scar like a scaffold,” she adds. Some doctors, like Dr. Buford, pair hyaluronic acid filler with platelet-rich plasma (PRP) to level up the scar and change the character of the overlying skin. Just like using filler in the face for aesthetic and anti-aging purposes, the results are not permanent and need to be repeated.

### **6. Neurotoxins**
- **Best For:** Surgical scars & scars that occur in a bony area
- **The 411:** One of the newer ways to correct scars is with [neurotoxin](https://aedit.com/aedition/comparing-neurotoxin-botulinum-type-a-injections-botox-dysport-jeuveau-xeomin) (think: Botox® or Dysport®), which can be injected into the scar to reduce muscle tension on scar tissue. “Using Botox® or other neuromodulators to reduce or eliminate muscle contraction in and around the scar has been shown to reduce hypertrophy and also to decrease fish-mouth or spread scars,” Dr. Weiser shares. Dr. Buford agrees. “Botox® is effective in a variety of scars,” he says. “When I place it in fresh scars all over the body, the scars tend to heal a little nicer.” But that doesn’t relegate the off-label use of Botox® just to body scars — it works on facial scars, too. “We know one thing that is consistent about scars is that they heal best under as little tension as possible,” he reiterates. “So, if you inject Botox®, you can relax the area to some degree. It’s a little trick, and it only works on certain areas.” 

### **7. Laser & Light Treatments** 
- **Best For:** Acne scars, keloids, raised or flat scars, red & discolored scars
- **The 411:** Light-based and [laser](https://aedit.com/procedure/acne-scar-treatment-laser-resurfacing) therapies stimulate new collagen to lessen the look of the scar. Light-based treatments, like [IPL](https://aedit.com/procedure/ipl) (intense pulsed light) and [BBL](https://aedit.com/aedition/benefits-of-bbl-hero-for-sun-damage-hair-removal) (broadband light), work well on scars on lighter skin. [Pulsed dye lasers](https://aedit.com/procedure/pulsed-dye-laser) (these target blood vessels in the skin) are best for reducing redness in scars, while [resurfacing lasers](https://aedit.com/aedition/guide-to-ablative-laser-skin-resurfacing) can soften the scar’s appearance and coloration. “These lasers involve the creation of controlled microscopic wounds in a specified percentage of the skin, which induces a wound healing response,” Dr. Weiser explains.

### **8. Microneedling**
- **Best For:** Superficial surgical & acne scars
- **The 411:** Perhaps the treatment du jour for unwanted scars, particularly acne scars, [microneedling](https://aedit.com/procedure/microneedling) (a.k.a. collagen induction therapy) creates microscopic wounds in the skin to stimulate new collagen that, in turn, smooths out the skin and the surrounding scar. It can also be [coupled with PRP](https://aedit.com/procedure/microneedling-with-prp) to further enhance the results. “Microneedling — especially with PRP — does work, and there are [studies](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4509584/) that show its efficacy,” Dr. Buford says.

### **9. Subcision** 
- **Best For:** Acne scars
- **The 411:** One of the most reliable ways to pull a deep scar out from under the skin and make it more flush with the surface is with [subcision](https://aedit.com/procedure/acne-scar-treatment-subcision). “This classic technique requires inserting a hypodermic needle into the skin directly beneath the scar to loosen and break the fibers that connect the scar to the tissue underneath it,” Dr. Weiser explains. “While this primarily helps to lift indented scars, it can also be helpful to release the collagen at the site of needle insertion to trigger a further healing response.”

### **10. Radiation Therapy**
- **Best For:** Stubborn keloids
- **The 411:** One of the more under-the-radar scar treatments is radiation therapy, which, [although promising](https://www.ncbi.nlm.nih.gov/books/NBK499973/), is strictly reserved for keloid improvement. “It’s used as a last resort for very challenging keloids,” Dr. Weiser says. If you are wondering how this therapy relates to cancer treatments, it is similar. “Radiation treatments entail the use of ionizing radiation — used for cancer/tumor treatment — usually externally applied to destroy existing collagen-producing cells and limit production of new ones,” she explains.

### **11. Scar Relaxation**
- **The 411:** Performed using a digital rotary tattoo machine to safely injure the skin and then repair it, this unique scar reduction method gives up to 80 percent improvement over six to 12 months and transforms almost every type of scar into soft, smooth skin. Scar expert Linda Dunn Carter, who invented [The DC Method](https://lindadunncarter.com/) over a decade ago, first abrades the skin down to the dermal layer to create new tissue while simultaneously forcing any dark pigment to purge. The tattoo machine breaks the bands of connective tissue that make up the scar to incite new, healthy tissue formation.

### **12. Scar Revision Surgery**
- **The 411:** Usually performed as the result of a poor surgical scar (think: [after a C-section](https://aedit.com/aedition/invasive-non-invasive-procedures-to-fix-appearance-of-c-section-scar)), surgical scar revision works best when a piece of the original scar is excised. But here’s the kicker: anytime you treat a scar with surgery, it will result in another scar — albeit a potentially thinner and flatter one. “Remember, the only way to erase a scar is to cut it out and replace it for another scar,” Dr. Bufford cautions. “But, sometimes, we can replace the old scar with a better-hidden one.”

## **The Takeaway**
Scarring is like a young child that you want to control but can’t. While scarless procedures sound promising, they’re far from reality, and you can’t do much to prevent occasional nicks and scratches. Fortunately, there are more treatment options to choose from than ever before for virtually every type of scar. 

*All products featured are independently selected by our editors, however, AEDIT may receive a commission on items purchased through our links.*

They say that every scar tells a story, but not every story needs to be retold. Here’s everything you need to know about improving that stubborn scar — no matter the cause.

How To Treat Every Type Of Scar

Scar Wars: How To Treat Every Type Of Scar

pam-sharpe-uJIGWpC3Oao-unsplash

Surgery can result in [different types of scars](https://aedit.com/aedition/minimizing-scars-after-surgery), and an important part of any post-op recovery routine is how to treat the incision site properly in order to minimize any scarring that may occur. When undergoing plastic and reconstructive surgery, the incisions and, by extension, scars are in the hands of highly trained surgeons that are known for their suturing prowess. 

But once you’re out of the OR, caring for those wounds is up to you and the healing process begins immediately. “I have patients start using medical-grade scar gel the day after surgery while they still have stitches,” says [Lesley Rabach, MD](https://lmmedicalnyc.com/), a double board certified facial plastic and reconstructive surgeon and co-founder of LM Medical in New York City. “It helps the incision to heal quicker and then it’s all about scar management.”

Scars generally fade over the course of the first year after a surgery, at which point professional [scar minimization procedures](https://aedit.com/aedition/minimizing-scars-after-surgery) (think: microneedling, lasers, chemical peels, dermabrasion, etc.) may be employed. A good at-home skincare regimen can ensure the marks disappear before any further treatment is necessary. Dr. Rabach warns against using oils because they have a higher chance of causing milia (a small cyst of oil) around the incision, which can complicate healing.  Instead, she recommends the following ingredients to treat surgical scars:

### **1. Silicone**
Surgeons have long recommended silicone strips or sheets to help prevent scarring, and using [topical silicone gel](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2918339/) can be an effective treatment as well. The ingredient can help dramatically reduce the appearance of scars by improving their size, texture, and pigment. Dr. Rabach suggests using a silicone gel once a day while you have stitches and upping the dosage to two times per day once they’re removed. Our pick? [SkinMedica Scar Recovery Gel](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.dermstore.com%2Fproduct_Scar%2BRecovery%2BGel%2Bwith%2BCentelline_41020.htm). We like it because it uses [lactic acid](https://aedit.com/aedition/guide-to-topical-alpha-hydroxy-acids-in-skincare) to brighten and exfoliate the skin and olive oil to help improve tone.

### **2. Epidermal Growth Factors**
Growth factors are proteins that tell cells to grow and heal. According to the *Aesthetic Surgery Journal*, [growth factors](https://academic.oup.com/asj/article/39/3/319/5061880) within a silicone formula are effective for surgical scar management. “They’re scientifically proven to get deep enough in the dermis to stimulate collagen and help with healing,” Dr. Rabach notes. Once your sutures are removed, she recommends alternating a product with growth factors (we like [SkinMedica TNS Recovery Complex](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.skinstore.com%2Fskinmedica-tns-recovery-complex%2F11289685.html)) with your silicone gel. Use one in the morning and one at night consistently.  

### **3. Sunscreen**
Scars are more sensitive to sunlight than normal skin and can easily darken or discolor. Keeping scars covered is your best bet, but, if sunlight is inevitable, don’t scrimp on sunscreen. [Dermatologists recommend](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4961501/) using a sunscreen with at least SPF 30 on top of your scar for 12 to 18 months to protect it. We’re fans of [iS Clinical Eclipse SPF 50](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.dermstore.com%2Fproduct_Eclipse%2BSPF%2B50%2BPlus_59903.htm) because it goes on sheer and is safe for face and body. Don’t forget to reapply throughout the day — every two hours if you’re in the sun or immediately after swimming.

## **The Takeaway**
As with any skincare routine, consistency is crucial. Continuously using silicone, growth factors, and sunscreen in the months following your surgery will boost the healing process and save you from additional treatments down the line. Ultimately, patience is the key to success. “It may take almost six months for your scar to disappear,” Dr. Rabach cautions. “But, if you follow the right instructions, it can almost go away.”

*All products featured are independently selected by our editors, however, AEDIT may receive a commission on items purchased through our links.*

Wellness

Healing and scar management start the first day after surgery. Here’s what you need to know.

Scar-Minimizing Skincare Ingredients To Use After Plastic Surgery

3 Scar-Minimizing Ingredients To Use Post-Op

shutterstock 571077550

No matter what kind of procedure you may be considering, following pre- and post-op instructions carefully will set you and your doctor up for success. Before going in for an aesthetic facial surgery like a [blepharoplasty](https://aedit.com/procedure/upper-eyelid-blepharoplasty) (a.k.a. eyelid lift), [rhinoplasty](https://aedit.com/procedure/open-rhinoplasty) (i.e. nose reshaping), or [rhytidectomy](https://aedit.com/procedure/smas-facelift) (read: facelift), it’s important to make sure you’re fully prepared at home with a gentler skincare regimen than you might be used to. The same goes for less-invasive cosmetic dermatology procedures like [chemical peels and laser treatments](https://aedit.com/aedition/chemical-peel-vs-laser-treatment-what-is-best-for-your-skin).

“A normal skincare regimen assumes that the integrity of the skin is not altered,” says [Jonathan Cabin, MD](https://aedit.com/provider/jonathan-cabin-md-956), a board certified facial plastic and reconstructive surgeon of the Center for Advanced Facial Plastic Surgery in Beverly Hills. “Many products that we apply to the skin in a regimen are fine to use when the [skin barrier](https://aedit.com/aedition/skin-microbiome-skincare-products-ingredients) is intact but, once disrupted from a procedure, can be very irritating and run a risk of scarring and hyperpigmentation.”

During a procedure, your skin undergoes trauma around the incision or area treated. For example, if you’re trying an [intense pulsed light (IPL)](https://aedit.com/procedure/ipl) treatment to remove a brown spot on your cheek, the skin around the brown spot can also be compromised and need to be treated more gently than normal for a period of time. If you’re undergoing surgery, the skin surrounding the incision site(s) can be stretched or temporarily disconnected from the underlying blood supply, which makes it more sensitive to chemicals and UV light. 

The most important considerations for adjusting your skincare regimen after a procedure are the location and type of procedure you’re having, notes [Adriana Lombardi, MD](https://aedit.com/provider/adriana-lombardi-md-12670), a board-certified dermatologist at the Skin Cancer and Cosmetic Surgery Center of New Jersey. Different procedures disrupt the skin in different ways, so there’s no one-size-fits-all rule to [post-op skincare](https://aedit.com/aedition/category/skincare). Here, we break down general guidelines for [recovering](https://aedit.com/aedition/category/recovery) from common surgical and non-surgical facial procedures.

## **Skincare After Surgical Procedures**
When it comes to post-surgical skincare, the main objective is to protect the incision site to [minimize scarring](https://aedit.com/aedition/minimizing-scars-after-surgery). “I give patients very specific instructions around incisions, as after care can be the difference between an invisible surgical result versus being able to tell something was done,” Dr. Lombardi explains. She gives her patients three incision-based rules to follow post-procedure.

1. Don’t expose the area to water for two days.
2. Starting the day after surgery, use a moisturizing barrier like [Aquaphor](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.ulta.com%2Fhealing-ointment-tube%3FproductId%3DxlsImpprod11821031) three times a day for two weeks.  
3. Use a silicone-based cream that contains sun-protection, like [Elta MD UV Clear Broad-Spectrum SPF 46](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.skinstore.com%2Feltamd-uv-clear-broad-spectrum-spf46%2F11370303.html), twice per day for three months.

Ingredients in your normal anti-aging skincare regimen can be very irritating during this time. Our experts recommend pausing on ingredients like [retinol](https://aedit.com/aedition/guide-to-vitamin-a-retinol-retinoids-in-skincare), hydroquinone, and [vitamin C](https://aedit.com/aedition/guide-to-topical-vitamin-c-in-skincare) two weeks *before* surgery and discontinuing their use for four weeks afterwards. Instead, focus on a gentle regimen consisting of simply formulated, thin cleansers (like [Cetaphil Daily Facial Cleanser](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.ulta.com%2Fdaily-facial-cleanser%3FproductId%3DxlsImpprod2360125) or [EltaMD Foaming Facial Cleanser](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.dermstore.com%2Fproduct_Foaming%2BFacial%2BCleanser_32762.htm)) and moisturizers (like [ZO Skin Health Hydrating Créme](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fzoskinhealth.com%2Fproducts%2Fhydrating-creme%3Fvariant%3D31799535599731)). “I see all of my patients the day after surgery, and, as long as everything looks good, I let them begin this regimen right away,” states Dr. Lombardi. 

The amount of time they’re on it depends on how they’re healing, but two weeks is standard. Sun protection is also vital, because the skin can be more sensitive to UV light after surgery. Being diligent with [sunscreen](https://aedit.com/aedition/best-lightweight-non-greasy-sunscreens-to-wear-indoors) usage (though you should be wearing it all day, every day regardless) can help decrease the risk of post-inflammatory hyperpigmentation (PIH).

## **Skincare After Non-Surgical Procedures**
Guidelines for non-surgical procedures generally require patients to use a refined post-procedure regimen. “There are many different lasers that target the skin in various ways,” Dr. Cabin says — and other non-surgical procedures that impact the skin barrier include chemical peels, facials, microneedling, radiofrequency, and more. While the amount of time you’re on a gentler skincare regimen varies, non- and minimally-invasive procedures often call for anywhere from three to seven days. 

Just like with facial surgeries, pre-op instructions normally require ceasing use of ingredients like vitamins A and C and hydroquinone prior to the procedure (about five days before). Post-procedure, Dr. Cabin often recommends using the [PCA Post Procedure Kit](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.dermstore.com%2Fproduct_The%2BPostProcedure%2BSolution%2BKit%2B%2BTrial%2BSize_12762.htm), which has trial-size versions of everything you need to begin your healing process.  

Once your post-op care timeline is up, reintroduce the more active ingredients into your regimen one by one to help prevent irritation. “We recommend the patient start with [AHAs](https://aedit.com/aedition/guide-to-topical-alpha-hydroxy-acids-in-skincare) and vitamin C and then add the retinol in last, as the skin tolerates,” he says. And, just like with surgical procedures, [broad spectrum sunscreen](https://aedit.com/aedition/how-to-apply-sunscreen-and-not-miss-a-spot) use is imperative for optimal results.

It should be noted that in the case of [deep chemical peels](https://aedit.com/procedure/deep-chemical-peels) or [ablative laser treatments](https://aedit.com/procedure/ablative-nonfractional-lasers) that result in raw, compromised skin, very specific post-treatment protocols will be put in place by your provider that likely include medicated ointments and soaks.

## **The Takeaway**
Before you undergo any type of facial surgery or procedure, make sure you discuss the expected pre- and post-op skincare protocol with your provider. Using the right ingredients at the right time and incorporating gentle products during the initial healing process can make a world of difference in the way the skin heals. After all, a good skincare routine [goes a long way](https://aedit.com/aedition/aesthetic-skin-aging-concerns-skincare-cannot-treat). “Despite all the potential restrictions in the short term, it is vital to use a high-quality skincare regimen to preserve the results of any cosmetic, anti-aging surgery once you’re recovered,” Dr. Lombardi concludes.

*All products featured are independently selected by our editors, however, AEDIT may receive a commission on items purchased through our links.*

From facelifts to laser treatments, following a post-procedure skincare protocol is imperative.  Here, The AEDITION breaks down exactly what you can and can’t use in the short-term.

Best Skincare To Use After Cosmetic Surgery And Facial Procedures

Is It Safe to Use Skincare After Facial Procedures?

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From scalding water and hot pans to too much sun and more, burns happen. “Some 1.2 million individuals experience burns in the United States [every year], and burn injuries account for approximately 500,000 emergency department visits,” reports [Samer Jaber, MD](https://aedit.com/provider/samer-jaber-md-3882), a New York City-based board certified dermatologist and founder of Washington Square Dermatology. “Of those visits, 9 percent (45,000) require hospitalization.” Here, The AEDITION breaks down everything you need to know about treating burns and preventing scarring.

## **How Burns Are Classified**
“First, second, and third-degree burns are categorized by the depth of the burn,” says [Nima Naghshineh, MD](https://aedit.com/provider/nima-naghshineh-md-600), a board certified plastic and reconstructive surgeon in Pasadena, CA. Below is what you can generally expect from each:

- **First-Degree Burns**: Also known as epidermal burns, they only damage the epidermis. “They do not blister but are red and painful,” Dr. Nima explains. “However, over the next few days, the pain and the redness tend to subside.” First-degree burns are superficial and usually don’t require medical attention.
- **Second-Degree Burns**: Also known as partial-thickness burns, they move through the epidermis and part of the dermis (i.e. the second layer of skin). “These are extremely painful and cause the skin to look red, swell, and blister,” Dr. Jaber says. They typically take one to two weeks to heal.
- **Third-Degree Burns**: Also known as full-thickness burns, they involve the entire thickness of the skin and are often less painful because of the nerve damage involved. After the third-degree trauma, the skin looks “dry, pale, charred, white, or black,” Dr. Jaber explains. Treatments and recovery vary depending on the extent of skin, nerve, hair follicle, and sweat gland damage involved.

Finally, fourth-degree burns represent the most severe and damaging burn injuries. “These burns damage fat in the body, muscles, blood vessels, bones, and joints,” Dr. Jaber says. Once the healing process begins, patients receive intensive care to prevent infection. Later, the doctor will explore skin grafting options, since the burned tissue will not regenerate on its own.

### **Additional Burn Classifications**
Beyond degree, burns are further broken down into classifications such as thermal, electrical, and chemical. “The importance of these categories is that specific treatments are often needed based on the type of the burn,” Dr. Nima says. “For example, certain chemical burns need specific neutralizing treatments. And there are additional considerations to look at for electrical burns that include deeper tissue burns that are not visible.”

Thermal burns range from scalds from boiling water to contact injuries, such as direct contact with a hot surface. Electrical burns, meanwhile, happen when the skin makes contact with heat-making electrical currents. “The severity of the injury depends on the current path, the body area affected, and the strength and duration of the electric current,” Dr. Jaber notes. Chemical burns occur when someone comes into contact with burn-causing chemicals. The severity of this injury depends on the amount of skin exposure.

## **How to Treat Burns**
After a burn, it is critical to know when to seek help. While small, superficial burns can be treated from home, burns that cover larger areas require medical attention. Depending on the severity, IV fluids (to treat dehydration), antibiotics, tissue removal, and/or skin grafting may be needed.

### **Treating First-Degree Burns**
“Simple burns like a sunburn or a first-degree burn is easily treated at home, if there are small enough areas,” Dr. Nima says. First-degree burns are commonly treated by “cooling the skin with cold compresses and using acetaminophen or ibuprofen for pain control,” Dr. Jaber explains. Applying a [fragrance-free](https://aedit.com/aedition/fragrance-free-beauty-skincare-for-sensitive-skin) moisturizer, like aloe vera, honey, or Vaseline, can improve wound healing.

### **Treating Second-Degree Burns**
With second-degree burns, blistering accompanies the pain and redness. “You should not pop the blisters, if possible,” Dr. Nima cautions. “The healing will occur on its own.” If there are raw areas, your doctor will prescribe antibiotic ointments or topical treatments, such as Silvadene, to help with scarring and preventing infection. Deeper second-degree burns carry a low to moderate risk of scarring, and they could potentially result in discoloration or pigmentation. “As a general rule, you should keep any burn area out of the sun and treat it according to medical advice,” he shares. “If excess scarring or thick scarring is a concern, silicone sheets and gels will reduce the damage.”

### **Treating Third- and Fourth-Degree Burns**
Third-degree and fourth-degree burns result in thick, contracted scars. There are a few options to address the appearance and functionality of the scarring, including removing the discoloration and placing healthy tissue on the site. A more in-depth procedure replaces the contracted scars and rearranges existing tissue to allow for more give. The latter surgery is needed if a burn resides at a joint site (think: the elbow or knee) to restore function and range of motion. In more advanced and complex cases, tissue from non-burned areas can be transferred to the burned areas to replace the scar altogether. These procedures require microsurgery and significant healing time.

## **The Takeaway**
Once a burn is fully healed, the resulting [scar can be treated](https://aedit.com/aedition/minimizing-scars-after-surgery) to improve tone and texture. “There are many treatments to improve scarring, including lasers like Fraxel, fractionated C02, or intralesional steroid injection,” Dr. Jaber says. Consulting with a board certified dermatologist or plastic surgeon will ensure you get the best treatment for your condition.

From classifications to treatment options, a dermatologist and plastic surgeon break down exactly what you need to know about caring for burns.

How To Treat First, Second, And Third-Degree Burns

Everything You Need To Know About Treating Burns

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It’s the stuff of coming-of-age novels and beloved TV series. Oh, and they happen to everyone. We’re talking about BLEMISHES. 

“We’ve all had the same horrifying experience during puberty or early adulthood — fretting over the pimple which appeared overnight, applying ointments, creams, and lotions in the hopes of reducing the size and appearance of the spot,” says New York City-based board certified plastic surgeon, [Ryan Neinstein, MD](https://neinsteinplasticsurgery.com/?gclid=Cj0KCQjwzZj2BRDVARIsABs3l9K1d7AMjKa6_zjzqG1V9xDivsN3frBctC1F6BvWD2xYLBrWW-Mr0b4aAsqkEALw_wcB). Not just a teenage condition, acne can impact men and women alike well into adulthood. And, if that is not enough, acne can leave behind a pesky parting gift: [acne scars](https://aedit.com/aedition/how-to-treat-acne-scars). 

According to [research published in The Journal of Clinical and Aesthetic Dermatology](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5749614/), 80 percent of people between the ages of 11 and 30 years have been affected by acne vulgaris and the vast majority have experienced some degree of acne scarring. The scarring is most common on the face, neck, and back. 

While over-the-counter and prescription lotions and potions can do the job, treating active acne lesions and post-breakout scarring sometimes calls for professional attention. Fortunately, there are treatments available in both dermatology and plastic surgery offices that can help heal and improve the appearance of the affected skin. “A multi-modal approach tailored to each patient greatly improves the efficacy of treatment and the patient’s final appearance,” Dr. Neinstein says. Below are some of the best in-office treatments for acne and acne scars.

## **In-Office Acne Treatments**
For the uninitiated, [acne vulgaris](https://aedit.com/aedition/how-to-treat-hormonal-acne-body-acne-cystic-acne-whiteheads-blackheads) is an inflammatory process affecting the pilosebaceous units of the face, chest, shoulders, and back. A pilosebaceous unit consists of a hair follicle, sebaceous gland, and a small arrector pili muscle. These units normally produce sebum and keratin. But when production is altered, a pimple or comedone can form. If bacteria like Propionibacterium acnes (a.k.a. P. acnes) get into the affected pore, the area of around the pilosebaceous unit becomes inflamed and red. To treat active acne lesions, an array of resurfacing and therapeutic treatments can be employed.

### **1. Light Therapy**
New York City-based board certified plastic surgeon [Jennifer Levine, MD](https://drjenniferlevine.com/), likes to use a device by Nordlys™ called Ellipse IPL™ to treat current breakouts and prevent future ones. Like other [intense pulsed light (IPL)](https://aedit.com/procedure/ipl) treatments, it uses narrow bands of light to kill bacteria and target the red discoloration of active acne. “This treats active lesions, and also prevents new acne from erupting, which then leads to less scarring,” Dr. Levine says. The procedure is good for [Fitzpatrick skin types I through IV](https://aedit.com/aedition/guide-to-fitzpatrick-skin-types), but it is not suitable for darker skin tones, she notes. Three to five treatments are required for best results (which are long lasting), though some maintenance may be required, Dr. Levine says. 

Another [form of light therapy](https://aedit.com/aedition/everything-you-need-to-know-about-the-benefits-of-light-therapy) that can banish breakouts? Blue light. [Jessica Weiser, MD](https://www.weiserskin.com/), a board certified dermatologist and founder of Weiser Skin in New York City, recommends Celluma blue LED light therapy to reduce P. acnes bacteria on the surface of the skin.

### **2. Microdermabrasion**
[Microdermabrasion](https://aedit.com/procedure/crystal-microdermabrasion) can be helpful to encourage skin turnover and decongest pores and small comedones — all of which speeds up the acne healing process while warding off future breakouts, Dr. Weiser says. 

### **3. Lasers**
At his New York City practice, board certified cosmetic dermatologist [Paul Jarrod Frank, MD](https://pfrankmd.com/), recommends the Aerolase laser to treat acne, inflammation, and the marks left behind. Treatments can be scheduled every two weeks and there is no downtime, he says. Additionally, a [Laser Genesis](https://aedit.com/procedure/nonablative-fractional-lasers) facial coupled with [cryotherapy](https://aedit.com/procedure/cryofacial) can do wonders to calm and soothe the skin. The combination treatment is “good to calm irritated, inflamed acne,” Dr. Frank says, thanks to the duality of the anti-bacterial and anti-redness laser with cold therapy. It takes 10 minutes, has no downtime, and provides results in as soon as 24 hours, he adds. 

### **4. Extractions**
You may be tempted to take pimple popping into your own hands, but extractions are best left to the professionals. “Medical-grade sterile acne extractions are an important component of a comprehensive acne treatment regimen,” Dr. Weiser says. 

## **In-Office Acne Scar Treatments**
Depending on the severity, acne patients may experience scarring and post-inflammatory hyperpigmentation in the aftermath of a breakout. “At times, inflammatory acne lesions can lead to long-lasting or permanent changes in pigmentation and scarring of the affected skin,” Dr. Neinstein says. “Multi-modal or combination treatments work to correct changes in pigmentation as well as scarring.”

### **5. Microneedling**
Known for its ability to improve skin tone and texture, [microneedling](https://aedit.com/procedure/microneedling) has shown promise as a treatment for acne scars. The tiny needles cause small areas of injury, which stimulate collagen production in the area. “This is beneficial since acne scarring is often due to a localized depletion of collagen,” Dr. Neinstein explains. 

While microneedling works well alone, it works even better when paired with additional modalities. Both Dr. Neinstein and Dr. Weiser say new devices that couple [microneedling with radiofrequency](https://aedit.com/procedure/microneedling-with-radiofrequency) offer an added benefit. As the needles enter the dermis, a pulse of energy is applied to further assist in the remodeling process. [Platelet-rich plasma (a.k.a. PRP)](https://aedit.com/procedure/microneedling-with-prp), meanwhile, can boost results, too. “Recent research has shown a significant improvement to acne-scarred skin when PRP was applied compared to microneedling alone,” Dr. Neinstein says. These therapies have minimal discomfort and very little downtime. 

### **6. Lasers**
Not just for active acne, Dr. Levine uses the non-ablative Nordlys™ Frax 1550 to resurface the skin. “There are many types of acne scars —ice pick, rolling, caters, etc. — so it requires multiple treatments,” Dr. Levine says. “And you may need to change the settings or passes in different areas.” Like the Ellipse IPL™, it is best for skin types I, II, III, and IV. Multiple sessions are required for best results, and “the treatment lasts as long as there is no new scarring from active acne,” Dr. Levine says. 

### **7. Dermal Filler**
A treatment option for depressed acne scars is injectable [dermal filler](https://aedit.com/aedition/everything-you-need-to-know-about-dermal-fillers). “These are particularly effective in treating ice pick and boxcar scars,” Dr. Neinstein says. An experienced injector will have knowledge of numerous fillers and their associated characteristics and potential collagen-building properties. “Each filler has a different lifespan within the skin,” he explains. “Numerous fillers have been shown to stimulate collagen production by fibroblasts, which will also improve the appearance and character of the damaged skin.”

### **8. Facial Fat Grafting**
For those who prefer autologous fat to fillers, [facial fat grafting](https://aedit.com/aedition/what-its-really-like-to-get-facial-fat-grafting) is another option. Fat cells (the smaller components of adipose tissue) are injected into the scars to improve volume. “This has shown promise in improving both the depth of scars as well as the skin quality,” Dr. Neinstein says. A sample of fat (often from the abdomen or thigh) is obtained using local anesthesia, the fat is processed, and it is then injected into the treatment areas in a manner similar to that of dermal filler, he explains. “Filtration of the fat to obtain smaller particles, such as stem cells, has been shown to rejuvenate and improve the overall appearance of the affected skin,” Dr. Neinstein explains. 

### **9. Chemical Peels**
Available in [superficial](https://aedit.com/procedure/superficial-chemical-peels), [medium](https://aedit.com/procedure/medium-depth-chemical-peels), and [deep](https://aedit.com/procedure/deep-chemical-peels) concentrations, chemical peels promote skin turnover, enhance healing, and reduce the pigmentation and discoloration caused by acne. They can improve skin tone and texture to restore a healthy, even complexion, Dr. Weiser says. 

### **10. Punch Excision**
Violence is never the answer, but Dr. Neinstein says a punch excision is a tried-and-true option for treating ice pick and boxcar scars. This procedure involves a small punch just larger than the scar made in the skin. “The small punch wound is then sutured with a single stitch or left to heal without a suture,” he says. 

## **The Takeaway**
When OTC and prescription topicals aren’t doing the trick, there are professional procedures that can help heal and prevent active acne and improve the appearance of scars. Consulting with a board certified dermatologist or plastic surgeon will ensure you’re on the best treatment regimen for your skin concerns.

Expert Opinion

While lotions and potions sometimes get the job done, treating active acne lesions and post-breakout scarring sometimes calls for professional attention. Here are some of the best in-office treatments for acne and acne scars.

Best Professional Treatments For Acne And Acne Scars

10 In-Office Treatments For Acne And Acne Scars

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Many women wear the scar left behind by their cesarean section as a badge of honor — if only I were one of them! Mine makes me feel disfigured. After three c-sections, my scar is wider on one side than the other. It is also so indented that it looks like it’s stuck to the abdominal muscles underneath, which causes flesh to bulge above and below. Needless to say, it's not ideal.

While c-section scars usually involve a horizontal incision that is approximately five inches wide, the generalizations end there. "The overall appearance of the scar is dependent on a number of factors, including how skilled the surgeon is at sewing the incision closed, how many layers of sutures are used, and your genetics," says [Richard J. Brown, MD](https://aedit.com/provider/richard-brown-md-4646), a board certified cosmetic plastic surgeon in Scottsdale, Arizona, and author of *[The Real Beauty Bible](https://drrichardjbrown.com/the-book/)*. "Some people just scar better than others."

It’s not uncommon for [c-section scars](https://aedit.com/procedure/embrace-scar-therapy) to go a bit rogue during the healing process. Some women have redness or puckering at the incision site. Others may experience indented scars. Hypertrophic (a.k.a. raised) scars are also possible, as are keloid scars, which are similar to their hypertrophic counterparts except for the fact that they spread outside the confines of the original wound.

So, what are your options if you are unhappy with the mark you c-section(s) left behind? We asked the experts.

## **Are You Planning to Have More Children?**
If you don’t like your scar and are planning to have more kids, you can hire a plastic surgeon to come to your next cesarean delivery and close the new incision (yes, this is really a thing). Plastic surgeons are nothing if not meticulous sewers, and, most importantly, they close in layers. 

In the case of a c-section incision, a plastic surgeon would begin by stitching the Scarpa's fascia (i.e. the type of fascia surrounding the abdominal wall) because the connective tissue has a high degree of tensile strength. By closing the fascia tightly and securely, it relieves tension on the above skin edges and helps to prevent scarring.

“I close the Scarpa’s fascia first, then the deep dermal layers, and then do the subcuticular closure on the top layer of skin," says Dr. Brown. But the expertise comes at a price. Plastic surgeons can charge anywhere from $3,000 to $5,000 for the suturing.

Since I don’t plan on having more kids, I have been talking to dermatologists and plastic surgeons about how to improve the appearance of my wonky scar. One thing to keep in mind before choosing a c-section scar treatment: timing. 

If you just had a baby a few months ago, you likely want to give your body some time to heal (that is, unless you are showing signs of infection). "The common belief is that it can take one to one and a half years to see a more finalized appearance of a scar," says [Gregory A. Buford, MD](https://aedit.com/provider/gregory-buford-md-1015), a board certified plastic surgeon in Englewood, Colorado. "During that time, many patients will see early changes to their scars (redness, protrusion, itching, etc.), which then often improve over time."

## **C-Section Scar Treatments** 
But if you, like me, have been dealing with your scar defect for years, there are surgical and non-surgical procedures to improve its appearance — or remove it altogether.

### **Microneedling with Platelet-Rich Plasma (PRP)**
Ever heard of the celeb-fave "[vampire facial](https://aedit.com/procedure/microneedling-with-prp)"? Well, consider this the c-section scar edition. [Microneedling](https://aedit.com/procedure/microneedling) alone involves using a handheld roller device covered in tiny needles (a.k.a. a derma roller) to make microscopic punctures in the skin. The process stimulates new collagen production, which, in turn, can improve the appearance and texture of a scar. While the treatment is most often associated with anti-aging, Dr. Buford says it can be helpful for scars as well. 

Adding [platelet-rich plasma](https://aedit.com/procedure/microneedling-with-prp) to the mix further ups the ante. According to a [study in the Journal of Cutaneous and Aesthetic Surgery](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4338464/), coupling PRP with microneedling intensifies the body's natural wound healing process by delivering concentrations of the person’s own growth factors to the site. 

The treatment begins with a dermatologist or plastic surgeon collecting five to 15 milliliters of blood from a patient's arm before putting the sample into a centrifuge to isolate the platelets and create the PRP concentration. After numbing and microneedling the affected area, the practitioner will massage the blend into the skin so that it can penetrate the micro-punctures.  

There’s minimal downtime — aside from a few days of minor bruising or inflammation — but three to six sessions (at around $500 each) are needed to see results.

### **Steroid Injections**
If you are dealing with a hypertrophic or keloid scar, a dermatologist can shrink the mark by injecting it with a corticosteroid solution. Steroids break up the bonds between collagen fibers, which reduces the amount of scar tissue below the skin, and they also act as anti-inflammatories to help minimize swelling, redness, itching, and tenderness. 

“These injections can be given every four weeks," says Dr. Brown, who notes that the shots can weaken the skin or potentially cause fat necrosis (i.e. lumps of damaged tissue) if not administered properly. 

The upside? Each session is quick — usually lasting no more than 15 minutes — and costs about $50.

### **Laser Treatments**
[Lasers](https://aedit.com/procedure/ablative-nonfractional-lasers) are another non-invasive option for improving the appearance of scars. “Pulsed dye lasers or light sources like [IPL (intense pulsed light)](https://aedit.com/procedure/ipl) can often be used successfully during the early healing period to reduce and potentially eliminate scar redness,” says Dr. Buford. 

A [pulsed-dye laser](https://aedit.com/procedure/pulsed-dye-laser), for instance, uses a yellow light to fade redness and flatten raised scars. IPL, meanwhile, is commonly used to treat sun-damaged skin and is believed to work on scars by targeting the blood vessel proliferation associated with collagen overgrowth during the healing process. 

In a [study by Aesthetic Plastic Surgery](https://link.springer.com/article/10.1007%2Fs00266-008-9161-7), 109 participants with hypertrophic scars from various causes (including surgery) were given IPL treatments in two- to four-week intervals. A reduction of scar redness, height, and hardness was seen in nearly all the patients (92.5 percent), and over half of the participants had “good” to “excellent” improvement. 

The number of laser treatments for a c-section scar varies, but Dr. Buford says “you usually need anywhere from two to six sessions for maximum effect.” Series range from $1,500 to $5,000.

### **C-Section Revision Surgery**
If your c-section scar isn’t responding to other treatments, is indented like mine, or has a shelf of skin hanging over it (which is common), your best bet may be to have the scar cut out so the skin can re-heal. And, while it may sound intense, a c-section scar [revision](https://aedit.com/procedure/zplasty-scar-revision) surgery isn’t nearly as painful or debilitating as a c-section itself. 

Unlike a cesarean section, the corrective procedure doesn't involve the abdominal muscles or uterine wall. Instead, just the skin and tissue are snipped, which is a much less invasive process (especially when you consider that the body has already had time to recover from pregnancy). 

"The challenge with the initial closure of a c-section scar is that the tissue itself has been stretched and is swollen when the closure is performed," says Dr. Buford. "Revising the scar at a later date allows us, as plastic surgeons, to operate on tissue that is now relaxed and more optimally positioned to create a nicer result."

To fix a shelf issue, Dr. Buford performs a "full thickness excision of the scar" that he extends to cover a greater area by converting it into an ellipse-like shape. "By doing this, I am removing not only the scar itself but also some of the lax skin around it," he says. "This can provide not only a nicer appearance to the final scar but also tightening of the midline abdominal skin. Who has ever complained about a flat, tight abdomen?"

Removing the whole scar (including the tissue underneath) in an ellipsis shape can also fix indentation issues by reducing the tethering (caused by scar tissue) that is pulling the scar inwards. “It allows skin edges above and below the incision to come together in a more even manner,” says Dr. Buford.

In case you needed further proof that the revision surgery is nothing like an actual c-section: It's an outpatient procedure done under local anesthesia that will have you back at work the next day (though you can’t engage in strenuous exercise for six weeks). “By six weeks, a scar has reached 80 percent strength,” says Dr. Brown. 

The cost for an in-office scar revision is generally between $500 and $1,000, but it can vary widely depending on the size and condition of the scar. It should also be noted that, in cases of extreme tethering, the plastic surgeon may have to cut down to the top of the muscle to release it, and the invasiveness could require an operating room and general anesthesia.

C-section scars can be a beautiful reminder of motherhood. But, since no two marks are the same, you may not love the way yours looks. Here, five invasive and non-invasive procedures that can improve the appearance of a cesarean scar. 