Scars can occur from surgery or from injury. A scar is the result of the normal healing of the body, and it is inevitable that scars will occur when there has been either surgery or injury. However, it may be possible to try to reduce the appearance of your scars.
"Been to this office before and the staff is wonderful. The doctor is great and I love his work."- Anonymous / Office Visit / Apr 26, 2018
"Breast Augmentation - Love the look and feel of my breasts, size is perfect! Dr Nachbar is professional and confident. Easy to talk to. Love Amber and Daisy, they took hours of their time to calm me down prior to surgery. Nice people, caring, compassionate and very real."- Anonymous / RealPatientRatings / Feb 26, 2018
"Labiaplasty - Truth be told, I have always been fascinated with plastic surgery. I truly believe it you want something done and you believe it will benefit yourself in the long run, I see no problem with finding an answer to your solution. Well truth be told, I found the answer to my solution. Since this was indeed my first procedure and taste of the plastic surgery relm, I had no idea what to expect. I was very pleased with how smooth the entire process was. I loved my doctor, the nurses were fantastic and I had a very easy recovery time. I am so happy with my results, I would recommend this procedure to anyone I deemed up for it. I felt very taken care of with no sense of judgment whatsoever. His office is very clean, beautiful and conveniently located. He is full of knowledge and is not one of those money-hungry surgeons who would just recommend a procedure because he wants to get paid. He is the type of doctor that would not perform a procedure on you if he felt that is was not necessary. I felt very secure with this because I knew I made a wonderful decision picking him as my surgeon. 10/10 would recommend and I will be going back in the future."- Anonymous / RealPatientRatings / Mar 15, 2018
"I cannot say enough to thank Dr. Nachbar and his staff for everything they have done for me. From the time of my first phone call I was treated with respect and valued. I requested multiple appointments before scheduling as new questions came up especially as I had consults with other surgeons who would suggest something different. Dr. Nachbar took his time to explain to me the differences and his opinions on what other surgeons had said. My husband works out of state and they had no issue with me facetiming him during consults. I feel like Dr. Nachbar was very realistic in what I could expect from my surgeries and he definitely delivered on what he said he could do. I never felt like he was pressed for time and I never waited around in the office to see him. He was always very prompt and the one time he was late (due to a major accident blocking all roads to the office) he was very apologetic. His staff was amazing and always made me feel welcome. They never seemed annoyed when I had to bring my kids to an appointment. Overall I have and would recommend him to anyone. I never felt like just another number or paycheck I felt valued and respected which is hard to find in the medical profession these days. Thank you again to Dr. Nachbar and his staff for helping me complete my weight loss transformation."- J.G. / Google / Mar 11, 2018
"Breast Lift - Good results.GOod care and the re"- Anonymous / RealPatientRatings / Mar 15, 2018
HOW scars occur
When we do plastic surgery, we know that scars will result. There are a number of factors that contribute to the development of more-noticeable scars, including how the injury or incision was made (how much damage was done to the surrounding tissues), how the injury or incision was closed (if it was closed), how the healing injury or incision was treated after it had been closed, and the genes of the patient.
Unfortunately, some people just develop thicker and more noticeable scars than others. A good way to get an idea of the kind of scars that your body forms is to look at the scars you have already formed. For example, a woman who has had a Caesarian Section and who is thinking about a Tummy Tuck could look to the C-Section scar to get an idea.
However, local factors are likely to play an issue. One of the most important of these is wound tension. We often see thicker scars when the wound is under tension after repair. In some cases, such as Tummy Tuck, tension is a desired result of surgery. In other cases, such as when larger tattoos are removed, tension may be a by-product of the primary goal of surgery.
what can be done about scars
Unfortunately, there is nothing that will eliminate scars, and when a scar has occurred, the goal is to try to minimize its appearance and any interference with function caused by the scar. There are a great number of interventions that may be appropriate for a given scar.
For example, we can remove the scar with surgical excision, and then close the resulting wound, with the hope that the new scar will be better than the old scar. This is more likely to be successful when something about the closure is different the second time, such as more careful technique (especially if a plastic surgeon did not do the initial closure), or less tension the second time (because the skin has relaxed somewhat since the first closure.
A variation of scar excision and closure is a modification in the design of the scar with one of a wide variety of techniques. One of these is the "Z-Plasty," which allows us to break up a tight scar, but there are many more revision designs available.
Other treatments of an existing scar can include injections, such as steroid injections, which can make a thick scar less thick, but which can result in a somewhat wider scar. Laser treatments have been used, which can reduce the redness of a scar somewhat more quickly (although the redness tends to fade on its own over time anyway). Microneedling is another treatment that has been used for scars.
Treatments you can do yourself include massage and silicone sheeting.
Massage is often done with a lubricant, such as Mederma or Vitamin E oil (cut open a Vitamin E capsule to get the oil). For this to work, the massage should be fairly firm, and preferably for fifteen minutes three times daily. This is more likely to be effective in the weeks and months following healing, but can be tried with scars of any age.
Silicone sheeting can also be effective, by applying continuous pressure. This sheeting is available at drug stores or online, and ideally is left on for 23 hours a day (i.e., except when you are taking a shower).
A preventive measure that can be used in the first few months following healing is a specialized silicone sheet with two lines of adhesive, designed to take tension off of the scar as it is healing, since we know that scars that heal under less tension tend to heal with less thickness and width. An example of this is the Embrace® dressing, which is available online in different sizes. This works best when started about four weeks after surgery, and kept on for about 60 days. Each dressing can generally be left on for 10 days before being changed. The dressing is applied with a special applicator so that the sheet is under tension when the adhesive is applied, and then pulls the two sides closer, so that they are under less tenion.
Plan Your Procedure
Because there are so many possible interventions for thickened or noticeable scars, and because there is no treatment that eliminates visible scars, please make an appointment for a complementary consultation, so we can discuss your situation and what treatments might help.