I've been reading all these posts from people who have scars that have stretched and I'm trying to figure out when is the most likely time it would happen. Would the stretching occur during the first few weeks or months? Or does it happen after a year or maybe five years. Is there a time after which you are most likely safe from your scar stretching, or can it happen many years later.

From my limited understanding, these are the facts:

1. All scars stretch, but do fade, with time; there is a difference.

2. The propensity for stretching occurs just above the ears.

3. The propensity for stretching occurs depending on the region where the donor tissue is extracted. Scars below the occiptial bump stretch more (some one correct me if I am wrong)

4. Scars can stretch at any time, and stretching can occur up to a year after the surgery.

5. The underlying factor that increases the likelihood of a scar stretching is the tension in closing the donor excision.

6. Time is the only healer, and no type/amount of topical preparation can reduce the appearance of a scar. (BTW, there is a new treatment, that is in its experimental stages for reducing the appearance of a scar)

mmhce gets some good pointers in. i don't agree with #6. Vitamin E oil and mederma really do help hypertrophic scars. If discussing just widening out due to lots of skin edge tension rather than hypertrophy, then I'd agree with mmhce.

I would add that if one makes it to 4 months with a good scarline, it will be extremely unlikely, but not impossible, that a bad scar will result.

Dr. Lindsey McLean VA

quote:

Originally posted by dr. lindsey:
mmhce gets some good pointers in. i don't agree with #6. Vitamin E oil and mederma really do help hypertrophic scars. If discussing just widening out due to lots of skin edge tension rather than hypertrophy, then I'd agree with mmhce.

I would add that if one makes it to 4 months with a good scarline, it will be extremely unlikely, but not impossible, that a bad scar will result.

Dr. Lindsey McLean VA

Should we be putting mederma on our scars every night?

For face cases, I tell almost everyone to do the gentle massage a minute before each meal for 4-6 weeks, and apply a little bit of vitamin E oil or mederma once or twice a day for a few weeks. If they have a history or are at increased risk of bad scars, this then becomes mandatory, not just a suggestion. And that free scar check I want people to have at a month is important...

For hair, I say the massage is important. Putting lotions and potions in your donor area can make that area pretty greasy, and quite frankly MOST people don't have much scar issues with us. If someone is coming specifically for a scar problem, revision, or if they were really tight, I make that a mandatory instruction.

Each doc probably feels a bit differently though.

Dr. Lindsey McLean VA

Dr Lindsey,

I'm 3 weeks post-op with absorbable stitches. The absorbables under the bridge has mainly disappeared but a few are still remaining above the ear.
Is it okay to apply lotions now or should i wait till all the stitches have been naturally absorbed/dried out?

check with your doc. he probably has an opinion. I used to use dissolvables for strips but think my scars are better with removables...

But, I routinely use dissolvables for scalp cyst/mole removals and never seem to have problems. Those are smallish incisions though.

Dr. Lindsey McLean VA