Facial Plastic Surgeon Reveals How to Minimize Scarring
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- Опубліковано 31 тра 2024
- "How do I prevent scarring after getting a cut, scrape, or after getting sutures in the emergency room?"
I get this question from a friend or family member on a weekly basis.
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The bad news is that two of the biggest factors that determine how badly you will scar are the degree of the injury itself (how damaging was it) and your skin type/genetics. Unfortunately, those two items are beyond your control.
0:58 You can't control the degree of injury
1:23 Your genetics affect how you scar
1:41 Clean the wound
2:10 Ensure you're up-to-date with your tetanus shot
2:44 Does the wound require stitches?
3:14 Stitches vs glue vs tape
4:32 Healing with stitches
4:50 Use peroxide to clean "weeping" and "crusting"
5:38 Cover the wound with non-antibiotic cream
6:35 How long do the stitches stay in?
8:09 Icing the area
8:50 New scars are pink and stiff. This is ok!
9:29 Use silicone sheets or gel to reduce scars
10:46 Laser resurfacing can sometimes improve appearance
11:24 Surgical scar revision
12:44 ER or wait for a plastic surgeon?
1) Dirty wounds must be thoroughly irrigated and cleaned and may require antibiotics to prevent infection. A tetanus booster is also a consideration if you can't clearly remember the last time you had one. Tetanus kills, and boosters are cheap insurance.
2) It is better to be examined and treated early, and have any areas that need sutures closed, as soon as possible. Do not wait to find a plastic surgeon days later - your final outcome has the best chances of looking good if repaired early. Yes, even by the emergency room doctor! Of course, if there is a plastic surgeon on call to the emergency room, that is the best-case scenario.
3) If the wound goes "all the way through" the skin into the fat/tissue beneath, it will need to be closed in layers. Dermabond ("glue") and/or Steristrips ("butterfly tapes") can close the surface of the skin and hold it together, but there would still be a separation in the deep layers of the skin or subcutaneous tissues. That separation increases the risk of a depressed, widened, or hypertrophic scar long term. There is NO substitute for properly performed layered sutures.
4) Cuts and scrapes heal best in a moist environment, free from excess scabbing. I usually recommend gently cleaning sutures with a peroxide-soaked q tip 3-4 times per day, only for the first 3-4 days. The peroxide gently dissolves crusting and dried blood that forms around fresh sutures. There is no need for peroxide after the first 3-4 days. Excessive cleaning (more than 3-4 times per day, or longer than 3-4 days) does more harm than good. In most cases, it is safe to shower 24 hours after sutures.
5) The clean sutures, and any scrapes/abraded areas that did not require sutures, should be kept constantly coated with a layer of NON-antibiotic ointment. I prefer Vaniply ointment, but Aquaphor ointment and Vaseline are good alternatives. All are over-the-counter. If you feel that you must use an antibiotic, plain bacitracin is the best choice. Neosporin, triple antibiotic ointment, or any other neomycin-containing products often sensitize the skin and do more harm than good due to dermatitis.
6) Icing and elevation can help minimize bruising and swelling, but you must be careful not to give yourself frostbite! Make sure not to put the ice pack in direct contact with your skin - use a towel as a buffer - and only ice for 20 minutes at a time, taking 20-minute breaks in between.
7) Optimal suture removal timings vary - face is usually 5-7 days, and body maybe 7-14 days. In general, the thinner the skin, the sooner sutures should be removed. I usually like to remove even "dissolvable" sutures at these times to minimize inflammation. Abraded/scraped areas that are not sutured, but kept moist with ointment, will usually heal up with new skin in these same time windows.
8) Once sutures are out or scrapes have healed, it is common that the affected skin is pink and stiff. I believe silicone ointments are much more effective than Mederma in helping the scars fade. Sunscreen and sun avoidance is also important. Dr. Nayak's own formulated scar gel, Advanced Medical Silicone Scar Gel, available without a prescription here (www.dermspastore.com/products..., is proven to improve the color, texture, and overall appearance of scars from surgery, injury, c-sections, cosmetic procedures, burns, or acne. Advanced Medical Silicone Scar Gel does not contain sunscreen.
9) It can sometimes be helpful to treat healing scars with a laser at 4-8 weeks. Surgical revision is usually not possible or prudent until 6-12 months after the injury when the tissues have relaxed and the scar has softened.
10) Final results take 1-2 years, and any residual scar will continue to improve slowly for many more years to come.
Thank you. This would help me prevent scarring..
This is so informative. Appreciate it Dr.
Thank you Dr. Mike! I'm in Branson, MO so practically a neighbor :-) I was told all this but didn't remember it all so it's good to hear it all again when I'm not freaked out after Mohs surgery.
Thank you for your time and professional advice
The phone call was everything! No other human at any other level of society can excuse themselves to take an unrelated phone call during their UA-cam video. Would we not feel Bieber obnoxious doing this? A policeman, a firefighter, a politician, a lawyer? Only a doctor. Love this video. Laughed out hardly when it rang and then he took it. Doctors are demi-gods of life and death among us.
Thank you for all of the useful information! Very well presented in my opinion..
Great advice Dr. Thank You!
Thank you doctor. May god bless you! Very beneficial video
Amazing Video Doctor! Thank You!! Notes taken!!
I had a basal cell carcinoma removed from my nose lip area...I had 3 treatments of laser therapy and massage the scar for 15 minutes twice a day and it’s only been 3 months and see a big difference..and I always make sure to wear a spf of 60 so that my scar doesn’t tan...
Very informative - thank you!
Excellent and informative video. I loved the delightfully casual style, especially taking the phone call and not editing it out! Really charming.
Thanks so much! Great video
This was a great video. I recently slipped in the shower and sustained a laceration by my eye/temple. I went to ER because I was concerned about concussion. The ER Dr opted to use dermabond and I received a tetanus shot. Within 3 days I went back to ER because I suspected it was infected. At that point, a Dr reopened and cleaned it up, put me on antibiotics, and wanted me to leave it open. I left it alone overnight but the next day I was advised to close it myself with steri strips so I did. Yesterday makes it one week out since I fell. I know the infection set me back on healing but the wound came together relatively well (the edges don’t seem to be sealed yet). Although I am concerned about it being raised or depressed so I’m going to look into the silicone products you suggested. Thank you for the information.
Excellent video
Really helpful. Thanks sir
Wonderful video thank you
Thank you. Informative.
Thanks for the information
Thanks very much for amazing video which is helped me in making the right informed decisions thank you so much for your content
Thankyou so much lovely man xx
Thank you for your video. Recently got a laceration to my nose and like most, am very afraid of how it will scar. A question about the Advanced Medical Silicone Scar Gel, can this be used with Scarguard? Your response is much appreciated!
Thank you 🙏
Thank you!!!! You helped me to decid to go to the ER on Sunday 1:30am instead of waiting for the doctor (which would have been a day or 2) and got stitches for a facial wound. Thank you for making this video!!!!!!
Mother of 3 little ones :)
Healy Lee smart move! Hope all went well.
I had an idea to put aquaphor on the scabs on my face from a car crash and it’s helped so much
This is an excellent and very informative video! Thank you for doing this. This is the kind of expertise that doctors usually don't share. This info is priceless. This should have millions of views! Thank you!
🎯🎯🎯
Thank you for the video! I met with an accident and a plastic surgeon made some sutures on my forehead and right beside my eye, and I have the scabs from other abrasions all over my face have fallen off, leaving pink skin behind. My doctor has prescribed Silicone sheets for 12 hours and Contractubex - an extr. Cepae, Heparin Sodium & Allantoin gel to be applied during the day. My question is, when is the right time to start this? My wounds have healed (except one - which is a small bit of yellowish scab) and are pink now. Also, when can I start using makeup to cover them up?
Thanks
Thank you doctor! I wish that the doctor that stitched me at the hospital would have given me your advice, fortunately it’s only been 3 days so I’m still in good shape! I was being treated with neomycin 😑
Hi😊
@Bright Star not too much, I did follow the advice on the video my scars are there but barely noticeable - it does work!
The link for the silicone gel doesn't work. How can I buy it? What a Great information u provided
Hi there. Is icing / elevation appropriate well after the sutures have been removed, two months after the surgery? At this stage would icing potentially improve the appearance of the scar? Thank you.
Thank you for this video. It is very informative! I have a question: Is it ok to cover the stitches with a bandage after applying vaniply or aquaphor? Thank you!
Thank you for the information. I just had a thyroidectomy and this was extremely useful. Thank you.
Sin Wa Li Yup you’re welcome!
This was a really nice and informative video. Liked and subscribed. I earned 5 stitches in my upper lip in a surfing injury 2 weeks ago. It left a railroad scar that I'm now caring for
Reclusively Social thank you! Good luck with the healing! Definitely consider the Biocorneum scar product linked in the description. Use code NAYAK10 to save 10% and get free shipping for orders >$100
I just had liproscopic surgery on the bottom of my esophagus, the doctor told me of have five SMALL holes in my stomach, turns out? Not so tiny! I know this isn't my face but I'm kind of short and my torso area isn't exactly long 🤣
I have now purchased the silicone sheets, and am going to get the cream as well. Worst case scenario I have to use some type of Korean skin whitening (JK), best case??? Your advice makes my life better. Thank you so much for making this video. It's truly appreciated.
Thanks for the video. I have been prescribed Retino-A and Elocon cream for skin abrasion (one-month-old). Is that okay to use for cut scars?
Dr. Nayak was looking to purchase the silicone gel you added to the comments how does it do for black skin that is recovering from surgery with internal sutures
Thank you! I had an incomplete Carpe Tunnel Release which is 2 inches long between my wrist and hand. Would you still suggest Biocorneum?
How can you clean the incision site with H2O2 and keep it covered w/ a cream if it's covered with Steri-Strips? I had desolving sutures for a dorsal wrist incision and I formed keloids around the specific areas where there were stitches still poking out. Was never offered silicone sheeting..so angry at how my scar has turned out and the doctor didn't address it at all.
Hi Doctor Mike,
Is DERMATIX ULTRA silicone? Can I start using it after 2 week of removing the sutures in a forehead wound?
I just had a scar revision surgery to fix a depressed scar from a apprentices surgery done years ago, while asked whether I should apply a silicon sheet, my doctor said that I should apply only micropore surgical tape on the new scar for my case instead of a silicon sheet, may I know what’s your opinion on it ?
Doctor, what about rubbing creams? I used to have a facial scar next to my nose, and I used some probably prescription (in Hungary) green partially or entirely made out of an onion extract. That thing started a long lasting allergic reaction as part of or on top of its function to make the skin peel(?) off. It peeled(?) (and eventually flaked) a lot. Today, it is not visible at all. It was over half an inch in length, and it was a very fine cut by glass. Is that no longer considered a best practice or it never was in the U.S. and/or in other Western countries?
Also, this video was amazing. My cosmetic surgeon told me none of this info, even though I probed him and the staff for info on scaring and would healing. I was told to keep the wound and sutures as dry as possible, to absolutely not use aquaphor, and that the wound could just heal on its own without any help.
Personally I think he gave
You wrong info. Wounds generally need moisture to heal. And also this Scar
Away that I use really helps to keep scarring at a minimum. But dont take my word for it.I would read some articles
About it and then confront him. Maybe you
Have some special kind of
Stitches or something that
Doesn't require this care.
Did it heal nice?
@@barbarasmith388 I am jus told by nurse today to keep it dry., I am really confused
It needs to be moist
How long do I use the bacterian for? If it's a fresh cut I am not sure which one to do. My doctor said to use that ointment for the first couple weeks or should I switch to the vaseline?
Thank you so much for the helpful hints on caring for your scar. I had a face lift 2 weeks ago, 2nd one in 10 months, still have a saggy chin, the one thing I wanted changed the most. Anyway, the same doctor did both and he has never come to talk to me about after care or anything really. The nurse told me to massage the scar, how do you feel about that? Also, I love the Vaniply you recommended and I also bought silicone gel. I wish I lived closer to you, I live here in Maine or I would make an appointment to see you. I have so many questions and concerns and I would just like to talk to someone. Thank you again for this helpful video, have a great day.......Mary (also, I'm 59 and my 2nd face lift I was awake.)
I am glad we have been of help to you! Maybe one day you will make the trip to St. Louis!
Hi there Dr. I just wanted to ask... i had this scar in my face... when it was sutured they used silk 2/0 and i notice that there were marks sameway with depression.... any suggestion?
Thank you for the advice!
Is general anesthesia or local used in scar removal
Thank you dr I recently had revision done on a nine year scar ( facial )
They recommended antibiotic cream , I’m not sure why then I went back for follow up the next week then they said to leave it dry. Very confused there a plastic surgery who’s been around for many years. Could have been in a hurry to get out, that’s horrible right.!?
Thank you for the very good info what to put on sutures during the time period
I love how you mention “NON” antibiotic ointment in this video. Many of us are actually allergic to antibiotic ointments, and i have actually become victim to very bad scarring due to excessive inflammation on a wound because i was told to use antibiotic ointment being a patient with ethnic skin who already is at risk for bad scarring. Excessive inflammation makes scarring worse. People with ethnic skin type being more prone to scarring, have to be very careful in following proper post operative, and a very important part of this is keeping inflammation down. I recently learned taking IBUPROFEN is actually good as a pain reliever because it brings down inflammation, so keeping that inflammation down is key. Also i think antihistamines can do this too. Some of us also are allergic to some suture materials so that can cause problems too. Compression is also good for scars. And too much tension on a wound can also cause bad scarring.
For scar treatment following MOHSprocedure for basal cell carcinoma on nose is silicone spf gel preferable to the cream.. (The video was immensely helpful)
Can I use vitamin c serum and dermaroller for finger surgery scar ?
I have a scar with glass splinter in my face between my eye brows ,I can feel the bigger glass ,but thier is smaller ones that itches sometimes at knight ,most a says it's too close to my eyes so it's best to leave it alone,but I'm very self conscious about the scar people says they don't notice it ,but as I look in the mirrow or do a video call it the first thing I see ,any thing I can do to get rid of the scar
And that's way doctors are late for appointments..They're making videos 😆 Thank you for the excellent information.
Can you apply aquaphor or Vaseline soon after a sutured laceration? If not how soon can you apply Vaseline after a fresh suture?
What differences for large holes in the face caused by TCA 100%?
Keep moist for 2 weeks? Regular massage and needling at 6-week mark? Anything else?
Hey doc. Did you hear from verteporfin for real skin regeneration instead of scarring
Can I use mupirocin ointment on my knee stitch? Or plain vaseline is ok?
Hi doctor, let say if i have very big abrasion on my face today, how soon should i apply vaseline on the wound.. Is it immediately or should i wait a few days?
Sir I have done scar revison scar Is now less noticeable.. but which cream should I use to remove the revised scar
Wat is treatment of internal scar tissue hardening.
Hello ~ In the video you mention BioCorneum.. but the link in section 8 above takes you to ADVANCED MEDICAL SILICONE SCAR GEL
, by Avani Derm Spa. Which is better to use for scarring? Do they have the same ingredients or is one superior to the other? Thank you for clarifying!
We created our own Advanced Medical Silicone Scar Gel by Avani Derm Spa to replace BioCorneum. Dr. Nayak created his own formula that is just as good but a lower price than BioCorneum!
Is there a solution of those railroads, I got 7 stitches just above eyebrows but doctor only made me wait till 10 -11 days. A nurse too, She said it's a sensitive area, you should wait. Then i asked another doctor at 10th day, I was informed 7 days at face was alright. At that moment I knew something bad has happened and after removing stitches I saw the railroads and now crying at my desk. Please HELP :/ Thank you
Thanks for the info, I used Bio oil for my forehead scar and it has caused breakouts near the scar. I have stopped using it.
Do you think bio oil has already made the scar worse since it darkened a bit, I used it just for 4 days
silvie khurana I’m sorry for the late response. I doubt it did any significant harm
I met with road accident 1 month back..got deep laceration cut on face sutured,Am massaging with Contratubex gel 3 times a day....and covering Silicon gel sheet for 24 hrs..After started using Contratubex gel, scar skin is turning black colour
I had liposuction surgery 3 weeks ago and one scar seems to be slightly indented than the others. Is it worth getting micro needling done on that wound to help fill it in? Great video by the way! 👍🏻
We would not perform microneedling on a scar that new. We recommend going to see the doctor that performed the liposuction for their opinion.
When is the best time to begin cross-fiber friction scar massage for the face or body? (Like in eyelid surgery) _Would it be 7-10 days out, after sutures have been removed or 2-3 wks to allow the body to naturally phase through wound healing?
Sir I hvv a cut mark on my face how to cure it
hey doc, thanks for the video. do you feel like all silicone gels are the same, and do you think that gel is just as good as the sheets?
also, my scar is in the middle chest area. won't the gel be removed if you sweat in summer?
RetroHunter06 I do not feel they are all the same. The one I mentioned in the video is superior, and stays on despite sweating. The link is below, and you can use code NAYAK10 to get 10% off plus free shipping of any order over $100
www.shopnayakplasticsurgery.com/products/biocorneum
Is it normal to have dents after removing stitches
Is this great for plastic surgery scarring?
What about staples?
I want this cream unfortunately I can see the ingredients 😒
How often should sutured, boulder patches be changed...every 7-10 days?
balarabb7 that is a really specific circumstance and there isn’t a broad rule on it!
How can I minimise surgery scar n flatten it
I can’t find the links
Thank you so much.Now I got a real good idea of what to do during this hard time for my skin.
hi im having keloid excised on my face, check area, followed by low dose of localize radiation. any advise on wound healing for that?
Gaetan Tchamba The same instructions would apply
@@NayakPlasticSurgery bactrin is better right
Bacitrin
Hi, I followed your advice and cleaned my surgical scar with hydrogen peroxide. My scar has worsened and it looks really hyperpigmented. I have not been outside since surgery. What can I do? I'm scared my skin is ruined.
I’m so sorry for you! Did it ever get better? Did you try a silicone gel or tape when the scar gad matured?
Did it ever get better? I know some things will get worse before they get better
Zinc oxide?
Hey , I found your video effective . I’ve a small scar on my forehead and I have done 2 lazers and after second lazer it seems to appear more fluffy . However i m getting rejected in my cabin crew interview due to this visibility of scar. Kindly suggest me something to conceal that scar.
Thank you.
.eei ohhfffvvepfdcleoj
Rosehip oil or aloe vera gel
How can I reduce redness on the scar and what are your thoughts on tca! Ty
I have 3% hydrogen peroxide, should I dilute it... If so, how much?
balarabb7 We use full strength, but you could probably dilute it by half with clean water if you like
Silicon and sunscreen Recs are 9:57
Hi i had five stitches in a 1.5 inch long cut on the top side of my index finger. Doctor also used glue. Should i wear a finger splint or is it not necessary?
I would ask the doctor you saw, as we do not know the extent of the injury!
The doctor told me I should keep my stitches dry. Or shouldn’t I?
My wound is on my face, can you please help me?
And when should I use Vaniply? 3 or 4 days later after using the peroxide? or A week later ? thank you!!!
Cool, I wonder if my surgeon when I was a kid, did this technique (it has scarred thickly, sadly).
God bless, Rev. 21:4
If I don't stich the wound just strips or glue? And I notice the scar is depressing? What will I do ?
How is your scar now?
Can you tell us why you don’t recommend mederma please
Youssef Kasmi: Mederma’s “key” ingredient is onion extract; however, scientific studies have shown it doesn’t do as well or better than silicone gel or silicone sheeting products. I would never risk the look of a scar by using a product that is ineffective, though marketed quite heavily.
Will peroxide dissolve the stitches?
Let Truth Prevail no
I wish have mer you before..I have a 6 years old girl with a scar on her upper lip (4years old scar) Any hope..she is been bullied.
Same with my daughter...praying for her
I had laser lesion removal on my forehead. Doctor said to let it scab over and the scab will fall. The scab fell off but I see a depressed area now.... what do I do?
Take collagen supplements for a few weeks and check for improvement maybe?
Thsnk you. Please provide the link for the siloc8ne gel to minimize scars
Lydia Moolenaar here it is: www.shopnayakplasticsurgery.com/products/biocorneum
Use code NAYAK10 You get 10% off, plus free shipping of an order of $100 or more
It depends who did the stitches
Hi, I'm 21 and I recently had a dog bite to my upper lip 2 weeks ago that went through the skin to open up into a 1p sized gap, but it did not go throuhh the muscle etc. I went to nhs a&e and had it glued together with steri strips. The strips started lifting on day 2 due to my oily skin so I put some elastaplast on, the glue remained strong. The wound began to weep after 3 days, but only at night so it dried under the strips before I could clean it up. After 7 days I removed the strips and the glue fell off overnight with some moisture. The cut did not close fully and is a bit depressed. I went to see my gp twice, once after 3 days and once after 1 week and they just referred me to a specialist surgeon in the next county who can only see me in 7 weeks. They did not recommend any topical treatments and told me not to put anything on the wound till it has 'healed', but I don't know what that is meant to look like. I feel like I'm just feeling round in the dark right now and it has really hit my confidence. I just wish a doctor would help me rather than just pawning me off. I feeli like its there way of telling me I'm screwed.
Hi Abigail, Dr. Nayak recommends you reach out to Julian Da Silva, a cosmetic surgeon on Harley St in London. He is a great doctor, and an in-person exam with him will help you get set off in the right direction!
Hi, I recently lacerated my eyebrow falling on ice. I received 7 stitches. The discharge papers I received encourage letting the wound dry and leaving it open at night to encourage scabbing over. Your tip to use vasiply seems to contradict this. From my research though moist wounds do heal better. Is there a reason my er doctor would encourage scabbing? I would like to use vasiply but I'm confused by this conflicting advice
We would recommend following up with your doctor if you have questions or concerns. Without you being our patient and us seeing the wound we can not give advice on what is best for your wound or tell you why one way was recommended over the other by your doctor!
@@NayakPlasticSurgery I did follow up thank you. I ended up using aquaphor to keep it moist, the sutures were removed today and I am so impressed with the results! Next I'll move to the silicon, thanks so much for taking time to share your knowledge! I'll recommend this video to anyone in need!
So glad! @@tlrlittle
Aloe ?? From the plant
Oh, it’s too late I suppose...My little daughter fell and got a wound near her eye and got glued and the wound healed open :( now the scar is shrinking.
Hi how is the scarring on your daughter now? My son he's 4 years old he got bitten by a dog on his face yesterday so scared of scarring on his face,any advice?
i had aquestion please, I want to show you the photo of my chin because After the Dui hit me in freeway , the ambulance take me to Er, but er did ruined my chin, make my chin worst , scar , fell tight till now, I need contec you please where I have to send my photo please?, t hank so much
Please send your photos and information to CC@nayak.net! We will be able to evaluate your chin and answer anymore questions you may have!
@@NayakPlasticSurgery how really you I need to send my pic
What about scar massage on the face? Also what about Maderma cream?
my sister got a scar right above her eyebrow and used maderma. it helped it a lot and it’s barely noticeable now!!😁
Maderma gave me an allergic reaction
Stitches only 2 to3 days on face.. No marks