Categories: Bariatric Surgery

How To Minimize Scarring After Weight Loss Surgery

Most bariatric surgeries leave either very small scars – in the case of laparoscopies – or no scars at all, as in the case of endoscopic sleeve gastroplasty. However, if scarring is a possibility for the procedure you want to have, there are things that you can do to minimize the scar.

Scars are the body’s way of healing a wound:

  • White blood cells rush to the wound to fight any germs or infection. When this happens, the wound may become pink or red, and may swell or feel tender to the touch
  • The body begins growing new tissue at the site of the wound
  • Collagen is produced and starts linking itself to itself, covering the wound
  • New granular tissue fills the inside of the wound
  • If there are stitches, they dissolve and fall out in two to six weeks
  • Any scab eventually falls off

The scar begins to form as new skin grows and strengthens the new tissue. Depending on the size and shape of the wound, the scar may be flat or raised, and may appear pink/red or white. In the case of brown skin, the scar may be significantly lighter than the skin color. Over time, these discolorations fade, though not always completely. A scar can continue to fade for up to two years.

Do’s and Don’ts of Scar Prevention

There are several things that you can do to prevent a scar from forming:

Do: Don't:
Get stitches to close an incision. Stitches pull the sides of the skin together and help make a smaller scar. Pick at the wound. The more times you pick a scab, the more times the body must re-heal the wound, and the more obvious the scar will be.
Avoid the sun, and use sunscreen, when that part of the body is exposed to the sun. Smoke. It causes blood vessels to reduce in size, which means fewer nutrients are carried to the wound.
Keep the wound moist. Petroleum jelly is ideal. Put too much faith in scar creams, but do keep the wound moist.
Massage the wound; it helps break up the scar tissue beneath the surface.
Monitor the wound for signs of infection (swelling, tenderness, a yellowish or greenish discharge) and call your doctor if you see them.

Keep these do’s and don’t in mind as you’re healing, but most importantly, be patient. “The first phase of healing takes three months, followed by a second phase that lasts another three months,” says Jessica Krant, M.D., assistant clinical professor of dermatology at SUNY Downstate Medical Center, in an interview with Everyday Health. At one year after the injury, the scar has basically formed, but even then it will still change and appear different a year after that.

Do Scar Creams Really Work?

There are several name-brand scar creams (or gels and sheets) on the market that say they will help reduce the appearance of your scar over time. Some have silicone among their ingredients, which can help hydrate the tissue and reduce collagen overgrowth. Others include Vitamin E oil, which helps soften the skin and keep it moist, or allantoin, a by product of uric acid that softens the skin protein keratin. Panthenol is similar to onion extract, which pulls moisture into the skin, as does lecithin, which forms a barrier that helps prevent evaporation.

Scientific research on the effectiveness of scar creams is scarce; since every individual heals differently, good studies must compare similar wounds on the same person.

A Los Angeles Times comparison of several medical studies concluded that there is little relation between advertised benefits and clinical evidence of over-the-counter products.

“The only thing really shown to help the healing process and minimize scarring, is keeping a wound moist and covered,” according to Dr. Joseph Sobanko, a dermatological surgeon at the University of Pennsylvania Health System in Philadelphia. “Most scar products do that. But there’s little evidence that they work any better than inexpensive petroleum jelly.”

And articles in the Journal of the American Academy of Dermatology showed that antibiotic ointments do not help, either, though they can contribute to antibiotic resistance.

The exception? Silicone gel sheeting. “Several articles reviewing 30 years of research suggest that it can speed healing and lead to thinner, softer, less red and less painful scars,” says the Los Angeles Times story.

Questions to Ask Your Surgeon About Scarring

As you and your surgeon discuss which bariatric surgery is right for you, be sure to ask about scarring. Two procedures – gastric balloon and endoscopic sleeve gastroplasty – are performed by inserting the tools through your mouth and down your throat while you are sedated, which means there are no scars at all.

Several other procedures – gastric sleeve, lap-band, gastric bypass and LINX – are performed laparoscopically, which means the instruments are inserted through tiny incisions in your abdomen. Only a tummy tuck creates a larger incision, typically placed between the hip bones and about the level of the pubic hair.

Here are some questions to ask your surgeon:

  • What should I expect in the way of scarring?
  • Is there anything I can do to minimize the appearance of any scars?
  • Are you trained in Hidden Scar techniques? (In this approach, doctors place the incisions in locations that are harder to see.)

If you have a history of keloid scar tissue, make sure your surgeon knows this ahead of time.

Scar Care After Surgery

Scars are a part of the normal healing process, but there are things you can do to make them as unnoticeable as possible. Care for your incision according to your surgeon’s instructions and be sure to attend all scheduled follow-up visits.

If you live in Los Angeles and want patient, experienced experts to answer all your questions, contact Soma Weight Loss. We performs all types of bariatric surgeries and can advise you what might be best in your situation. Call us toll-free at 855-766-2411 (855-SOMA-411) or contact us here.

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