Risk Factors For Scarring

• Age: Our skin becomes less elastic and becomes thinner, as we age. This is because collagen (which makes the skin elastic) changes as we age, and the fat layer under our skin becomes thinner. The result of these changes, along with sun exposure, smoking, exposure to the environment and other lifestyle issues, means that skin does not heal as well or as quickly as we age. The benefit to age is that the imperfections that occur over time, like sun damage, work to help conceal scars that might be more obvious on younger skin.
• Skin Tone and Complexion: Some skin colorations are more likely to scar than others. Those with dark skin tones /afro-american, indian etc./ are more likely to form hypertrophic and keloid scars, which are characterized by an overgrowth of scar tissue. Some scars tend to blend in better with darker skin while people with fairer skin color may find that their scars are more noticeable.
• Depth and size of The Incision: A large incision is much more likely to leave a scar than a small incision. The deeper and longer the incision, the longer the healing process will take and the greater the opportunity for scarring. The larger incision may be exposed to more stress when moving, which can cause slower healing.
• How Quickly The Skin Heals *: How quickly the skin heals is a personal thing and can change with illness or injury.Some people are blessed with quick healing and minimal scaring as well as others heal much slowly and not with minimal scars.
• Smoking: Smoking increase the risk for scars, it can also slow the healing process.
• Drinking: Alcohol dehydrates both the body and skin, which decreases the state of health. For proper healing it`s preferable to avoid alcohol and use non-caffeinated beverages.
• Nutrition: Make a balanced diet with a focus on protein intake (chicken, pork, fish, seafood, beef, dairy) to allow the skin to heal. For people who do not like eating meat, soy products provide an excellent alternative.
• Hydration: Dehydration happens when there are not enough fluids into the body. In severe cases, this can cause electrolyte imbalances and heart issues. Guessing if the body is well hydrated, is checking the urine- it will be almost colorless or light in color.
• Weight: Being overweight can be a greater risk for scarring, because the fat under the skin can work against plastic surgeon`s best efforts to close the incision seamlessly.
• Rest: If the doctor suggests that a patient rests for two weeks, it`s preferable not to go back to work after one week of healing. Exhausting the body will not help the wound heal and can actually slow healing. Putting stress on the incision by lifting, bending or doing anything that stretches or puts tension on the incision, should be avoided
• Proper Wound Care: The action recommended by the surgeon may be the single most important thing a patient can do to prevent scars. Taking measures to prevent infection, refraining from using ointments and remedies that are not prescribed, are essential to healing without scars.
• How to Identify an Infection **: If the incision becomes infected, it is important that a patient can identify the signs of infection and seek help immediately. An infection can seriously impair healing and may contribute to scarring.
• Chronic Illness: Diabetes and other illnesses can slow healing. For the best possible outcome, the surgeon should be notified so an illness could be well-controlled before surgery and during recovery.
• Sunlight Exposure: Avoid having sun on the incision whenever possible. If the scar is in place that is difficult to cover, such as face, a patient should wear a sunscreen. The surgeon should advice when it is safe to apply ointments, but it is usually safe to do so when the sutures are removed or the incision has closed completely.

* If you are prone to forming keloid scars, talk to the surgeon about having a steroid injection to prevent the formation of another keloid.
** Symptoms of An Infected Surgical Incision

- Fever: Feeling chilled is often associated with fever. It can also decrease your appetite, lead to dehydration and a headache. A fever above 36,7 should be reported to the surgeon.
- "Hot" Incision: An infected incision may feel hot to the touch.
- Hardening / Swelling of the Incision: An infected incision may begin to harden as the tissue underneath may be inflamed
- Redness: An incision that gets red, may be infected. Some redness is normal at the incision site, but it should decrease over time, rather than becoming more red as the incision heals.An extremely red incision should be reported to the surgeon.
- Incision Drainage: Foul-smelling drainage may be a sign of an infected incision. It can range in color from blood-tinged to green, white or yellow.
- Pain: The pain should slowly and steadily diminish in the healing process. If the pain level increases for no reason, it can be a sign of a developing infection in the wound. It is normal for increased pain if "overdoing" an activity or decrease a pain with medication, but a significant and unexplained increase in pain should be discussed with the surgeon.

One of the most common symptoms of an infection, or an infection that is moving through the body, is that the patient feels tired and lack of energy or sleep more than usual. These feelings are also common for patients who are recovering from surgery who do not have an infection. The difference is that when recovering from a surgery most people feel a bit better each day, rather than feeling better for a few days then suddenly feeling exhausted and lethargic as can happen with infection.