Dr. Boynton’s Approach to Scar Management – Easy as 1, 2, 3
Fear of “scars” is really a huge impediment to patients that are contemplating plastic surgery. While no one can absolutely predict what the incision or “scar” will look at in its final, “mature” appearance, the good news is that the science around “scars” has definitely gotten better!
As an aesthetic-based plastic surgeon, my focus is on cosmetic procedures. I have a very active practice with breast revision, breast lift and breast augmentation, as well as “mommy makeovers.” As one of my mentors taught me more than 15 years ago, “Shape wins over scars.” When women are seeking an “uplift,” shape is the most important variable. There are even polls answered by female patients to back this up. The word “scar” already has bad connotations, which is why I prefer to use the term “incision lines.” That is really what they are – incision lines. After surgery, the incision will mature, and the typical “redness” or “brown color” associated with it will typically fade. The fact of the matter is, this takes time. In my experience, the final incision lines are generally fully mature and maximally faded by 12-14 months in most patients.
For procedures such as breast lifts, tummy tucks, arm lifts, and even thigh lifts, I employ a “1, 2, 3 approach” I have developed that has been state-of-the-art in optimizing incisional healing.
- Step 1: At the time of surgery, I use the DERMABOND® PRINEO® Skin Closure System – a newer “skin glue” that is stronger than traditional skin glue, even as strong as a layer of suture. This stays on the incision for three weeks, getting most patients through the basic early healing phase.
- Step 2: Next, I change to embrace® Active Scar Defense, which is a tension-unloading silicone sheet that covers the incision to relieve stress and tension produced by movement. This is something I do for another four to eight weeks, depending on the patient’s needs.
- Step 3: Finally, the last step is to apply bioCorneum®+ silicone gel scar cream, which forms an invisible, waterproof silicone layer over the incision as it continues to heal. As it guards against bacteria and other harmful elements, this silicone sheet has proved to help soften, flatten and smooth incision lines, as well as diminish discoloration and reduce itch, discomfort and other effects associated with scar healing. Furthermore, bioCorneum®+ contains SPF 30 to help protect against potentially detrimental sun rays throughout the maturation process.
Ultimately, by employing this three-step process, I have found that my patients’ incision lines heal exceptionally well, often becoming virtually undetectable with time.
– James F. Boynton, MD, FACS