Scar Care After Surgery: What Your Scar Needs Now

Scars remain after every operation, and even with the greatest care, they cannot be completely avoided. However, with good and consistent scar care, you can positively influence the later appearance of scars and prevent symptoms such as itching and feelings of tightness. But what does proper care actually look like?

As a specialist in plastic and aesthetic surgery, scar care is, for me, part of every surgical procedure and important for achieving an aesthetic result. Below, I would like to explain how you can support tissue regeneration with ointments and massages, when it’s best to start, and what options exist for optimizing scars that haven’t healed well.

How a scar forms and why the first months matter

When the skin is cut during an operation, the body forms replacement tissue at this site to close the wound again. This scar tissue, however, consists of connective tissue, so unlike normal skin, it lacks features such as blood vessels, sweat glands, pigment cells, and hair.

The healing process takes place in three phases. In the first one to three weeks, the wound cleanses and closes itself; afterward, over a period of several weeks to months, new tissue forms during the so-called granulation phase (also called the proliferation phase) that fills in the defect. During this phase, the fresh scar is often still noticeably red and stands out clearly from the surrounding skin. Finally comes the remodeling phase, also known as the differentiation phase, during which the collagen fibers mature.

Complete maturation can take one to two years. However, the first weeks and months are decisive for the later appearance. During this time, the scar may look stable on the surface, but it isn’t yet. Mechanical strain that is too early or too intense can easily damage the still-fragile fiber structure. The result is often a wide or raised scar. To achieve a pale, soft scar that sits flush with the skin, proper scar care is important.

What is scar care and what is its goal?

Scar care can influence the later appearance of a scar as well as its mobility once it has fully matured. It also helps relieve accompanying symptoms such as itching and pain. What good scar care includes depends on several factors, such as the location and size of the scar — for example, whether it’s a relatively small scar after a facelift or a larger scar after a tummy tuck.

In most cases, scar care involves applying special creams, gels, patches, and dressings or compression garments. The latter plays an important role, for example, with very large scars. Targeted massages, consistently applying sunscreen with a high SPF, and special treatments such as microneedling can also support scar healing, helping to achieve a flat and barely noticeable scar.

Good scar care can:

• accelerate scar healing
• improve the scar’s mobility
• relieve pain, itching, and tightness
• make scars more elastic and less visible
• prevent complications such as infections

What does good scar care look like?

The most important thing is patience. Scars need time to heal and fade. The tips I recommend below help with this process, but they cannot bring about wound healing on their own or turn a still fairly fresh, reddened scar into an invisible one overnight. It is also completely normal for a freshly sutured wound to look less noticeable than the thicker, redder scar that appears afterward during healing. This is not a deterioration and does not require scar correction.

Avoiding smoking

In fact, you can lay the groundwork for good scar development even before surgery by abstaining from nicotine for several weeks beforehand. This improves oxygen supply and reduces the risk of a wound healing disorder, which in turn affects scar formation.

Scar massage

The body wants to close wounds as quickly as possible and therefore deposits collagen in a disorganized way. This can result in a firm, matted network of tissue. With regular massages (only after the wound has fully closed), you can loosen this tissue. Kneading stimulates metabolism, promotes blood circulation, and softens the skin. As a side effect, feelings of tightness diminish.

You can knead the scar firmly. For example, take it between your thumb and index finger and roll it back and forth. Do this for a few minutes at a time, several times a day. If you’d like, I’m also happy to show you the best approach for your specific scar. You can combine scar massage with creams and ointments.

Creams, ointments, and patches

Applying nourishing products such as silicone (as scar gel), scar ointments (e.g., with allantoin), or special scar patches from the pharmacy helps protect the tissue from drying out and keeps it supple over time. The goal is to relieve acute redness and itching, as well as to prevent hardening. Data from various studies show positive effects on the later thickness and color of the scar. However, achieving results requires a lot of persistence. It’s best to apply the product several times a day, over the course of months.

Sun protection

Skin protects itself from UV radiation by producing pigments (melanin) in melanocytes. Scar tissue, however, cannot do this. Because melanin is missing, the risk of sunburn and skin cancer is significantly increased. Hyperpigmentation (permanent discoloration) can also occur at the edge of the scar, causing it to stand out later from the surrounding skin. This can be prevented by applying sunscreen (SPF 50+) or wearing long clothing.

Compression therapy

After body-contouring procedures such as a tummy tuck, compression is used as additional support. Through even, widespread pressure, the scar stays softer and more flexible, doesn’t overgrow, and remains more flexible later on, so that restrictions in movement rarely occur. It’s important to wear the compression garment consistently, typically around the clock.

Good to know: You can also turn to home remedies, such as olive oil or clove oil. Aloe vera and ointments containing onion extract can sometimes be helpful as well. However, you should avoid vinegar and similar irritating substances, as well as unknown ointments from the internet.

The most common mistake in scar care: too early and too much

After a procedure, many people want to do something right away to positively influence scar formation as much as possible. That’s understandable, but doing so can actually impair wound healing and lead to undesirable results. That’s why I generally advise my patients not to apply care products to wounds that haven’t fully healed or are still weeping.

I recommend starting scar care only once the wound is completely closed, with no scabbing or weeping areas, and no signs of inflammation remaining. After surgery, this is usually reached around the time the stitches are removed. Until then, a simple, basic moisturizing care routine is generally sufficient.

What if the scar doesn’t heal as hoped?

The vast majority of scars after surgery heal without any problems with good scar care, continuing to fade and causing no issues. Sometimes, however, due to predisposition or mistakes in care, tissue overgrowth occurs, which in medicine is referred to as a hypertrophic scar (a thick, raised scar) or keloid (tissue growth extending beyond the wound).

The good news is that treatment options exist in such cases. The claim that nothing can be done about scars after a certain amount of time is false. There are always ways to improve an unattractive scar through smoothing or the injection of certain active substances. The following have proven effective:

• Cortisone injections: slow down excessive tissue growth
• Laser treatment: softens hardened areas and smooths out unevenness
• Cold therapy (cryotherapy): freezes the scar tissue

In some cases, improvement can also be achieved with compression therapy. Sometimes, however, only surgical correction will help. In my practice for plastic and aesthetic surgery in Frankfurt, I use this approach, for example, to reduce very raised scars or to re-create scars and relieve tension.

If you have a scar (after surgery or also significant acne scarring) that hasn’t healed the way you wanted or is causing you problems, feel free to schedule a no-obligation consultation. Simply call or use our online booking system.