In a recent interview with Life & Style, the former star of “The Hills” described a variety of post-surgery scars ranging from a two-inch long blemish under her chin to lumpy legs, uneven breasts and bald spots left from a brow lift.

“People have fewer scars from car accidents than I have on my body,” Montag told the magazine.

All plastic surgery but especially major surgeries like tummy tucks and breast reductions, can involve scarring. Ask your doctor to show you a picture of what the scar looks like beforehand. Another important question is what sort of treatments they offer to minimize scarring, for example silicone gel (e.g. Strataderm), silicone sheeting or laser procedures. It’s not always easy to know in advance whether or not you’re likely to scar. Some people are more prone to scarring than others. People heal differently, and patients with a poor history of wound healing or keloid scars are at high risk of scarring.

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British biopharmaceutical company Renovo announced that its Phase I dose ranging clinical trials designed to establish the safety of Juvista® following the surgical excision of bilateral earlobe keloids met all primary safety objectives. However, due to the insufficient sample size there is no data about efficacy of the product.

Juvista (INN: Avotermin) is a therapeutic application of human recombinant Transforming Growth Factor Beta 3 (TGFβ3). Clinical trials are investigating the effects of intradermal injection of Juvista applied to skin wounds created either by surgical incision or excision, at or shortly after the time of surgery on the appearance of the subsequent scar.

When your wound starts to heal the body produces more collagen which gathers around the damaged tissue and seals it. However, in keloid scars the collagen production doesn’t stop and the scar extends beyond the borders of the original wound in the form of dense fibrous tissue.

Keloid scars are raised and range in consistency from soft and doughy to hard and rubbery. They can appear anywhere on the body although they usually form in the area of shoulders, cheeks, earlobes and neck area. Burn scars or infected lesions, including acne, are more likely to form keloids. Keloid scars sometimes itch and may be painful. Keloid scars are 15 times more likely to occur in darker-skinned individuals, may be familial, and tend to develop more readily during and after puberty.

While keloid scars are difficult to treat, combination treatments seem to be the most effective. International Clinical Recommendations on Scar Management highlight a primary role for silicone and intralesional corticosteroids in the management of a wide variety of abnormal scars including keloids. Silicone is also recommended as first-line prophylaxis for keloid scars. Other options include surgery (high risk of recurrence), radiotherapy, cryotherapy, and laser.

If your skin is keloid prone, you should avoid piercings, tattoo and any unnecessary incisions, such as plastic surgery. You should treat acne thoroughly to reduce lesions and potential for scarring or, if surgery is necessary, silicone may be combined with intralesional steroids or other treatments (above) to reduce the likelihood or size of keloid scarring.

Acne is the most common skin disorder, affecting around 15% of the adult population and up to 80% of adolescents. Facial scarring because of acne occurs to some degree in most cases. The majority of acne scars are flat and depressed below the surrounding skin (atrophic), generally small and often round with an indented or inverted centre. To prevent acne scars, do not pop, squeeze, or pick at acne; do not pull scabs of acne; seek treatment early for acne that does not respond to OTC medications.

Types of Acne Scars:

–          red and/or hyperpigmented marks: a post-inflammatory change that usually disappears in 6-12 months

–          acne scars – icepick: depressed scars, deep, narrow and sharp; usually too deep for dermabrasion or laser skin resurfacing

–          acne scars – boxcar: depressed scars, round with sharp edges

–          rolling acne scars: depressed scars, wavy texture in the skin

–          keloids and hypertrophic scars are raised acne scars that may become larger and more noticeable, sometimes painful and itchy.  

Silicone gel like Strataderm is effective for treatment of acne scars and prevention of keloids and hypertrophic scars. Other effective treatments for depressed acne scars include laser skin resurfacing, dermabrasion, scar surgery (punch excision, punch elevation, punch graft, subcutaneous incision), fillers, chemical peel, microdermabrasion and similar procedures that you should discuss with your dermatologist. For raised acne scars, like keloid and hypertrophic scars, your doctor might consider options like intralesional injections, cryotherapy, surgery, laser and light therapy. Your dermatologist will be able to create a treatment plan based on the type of your acne acne scars, results you can expect, and your medical history.

Acne Scars:

Strataderm, a silicone gel for scar treatment is now available on Alice.com. Strataderm is ideal for safe and effective treatment and prevention of scars including:

–       burn scars
–       cesarean sections scars (C-Section scars)
–       acne scars
–       keloid scars
–       hypertrophic scars
–       plastic surgery scars (e.g. breast augmentation scar, rhinoplasty scar, eyelid surgery scar, liposuction scar, tummy tuck scar)
–       scars related to cancer (e.g. mastectomy scar, mole removal scar, melanoma removal scar)

We get asked a lot how effective silicone really is for scar treatment and prevention. With a number of products on the market that show little or no efficacy (e.g. onion extract creams, which have been proven to be no better than a cheap petroleum gel) it is not surprising that people don’t really trust all the claims.

However, this is a good example of silicone gel’s effectiveness for scar treatment. A silicone gel (Strataderm) has been applied to a linear hypertrophic scar 14 months after mole removal surgery (nevus excision). After only two months of use the difference is pretty obvious (left scar remained untreated, right scar treated for two months):

 

Silicone’s efficacy and ease of use are the reason why silicone gels have become the product of choice for plastic surgeons and dermatologists worldwide when treating and preventing scars including:

–       burn scars
–       cesarean sections scars (C-Section scars)
–       acne scars
–       keloid scars
–       hypertrophic scars
–       plastic surgery scars (e.g. breast augmentation scar, rhinoplasty scar, eyelid surgery scar, liposuction scar, tummy tuck scar)
–       scars related to cancer (e.g. mastectomy scars, mole removal scars, melanoma removal scars)