Skin of Color - Surgery


    Skin of Color - Surgery

    Q: What should people with darker skin look for in a plastic surgeon?
    A:

    Regardless of skin type, always choose a licensed surgeon who is board certified by the American Board of Plastic Surgery. Look for a surgeon who operates in an accredited, state licensed surgical facility. Cosmetic surgery can safely be performed in a hospital, a surgicenter, or an office-based surgical facility. Wherever your surgery is performed, be sure that the surgeon has operating privileges in an accredited hospital for the same procedure.

    Look for an experienced surgeon with whom you have a good rapport. Experienced plastic surgeons perform a wide range of cosmetic surgeries, so ask about your potential surgeon's experience with your skin type and any issues your skin might pose. The right surgeon will be sensitive to your concerns, and your satisfaction will be enhanced when you and your doctor can candidly discuss your goals and agree on realistic expectations.

    Q: Is scarring a concern after having plastic surgery?
    A:

    Yes. Scarring is a natural part of the healing process. Health, age, genes, sex, and ethnicity factor in the degree of scarring. Some people, especially those with deeper skin tones, have a tendency to produce prominent, raised scars. However, most patients of color heal well if they follow their surgeon's advice before and after a procedure.

    While some degree of scarring is inevitable regardless of skin color, modern surgical techniques make it possible to hide most scars. Discuss scar placement and after care with your surgeon so you know what to expect.

    Q: Are keloids common after having plastic surgery?
    A:

    No. Keloid scars, considered the result of an overly aggressive healing process, usually extend beyond the original incision site and do not fade with time. They are not common after plastic surgery.

    However, people of color may experience what is called "hypertrophic" scarring. These raised, red scars resemble keloids but do not extend beyond the initial incision. They diminish over time, but may take a year or two to resolve.

    A number of factors influence scar formation, including heredity and health. Your surgeon will evaluate your risk of scarring based on the information you provide.

    Q: Is there a special course of treatment available to prevent scarring for people with darker skin?
    A:

    No. Keloid scars, considered the result of an overly aggressive healing process, usually extend beyond the original incision site and do not fade with time. They are not common after plastic surgery.

    However, people of color may experience what is called "hypertrophic" scarring. These raised, red scars resemble keloids but do not extend beyond the initial incision. They diminish over time, but may take a year or two to resolve.

    A number of factors influence scar formation, including heredity and health. Your surgeon will evaluate your risk of scarring based on the information you provide.

    Q: What is the expected recovery time?
    A:

    Generally, recovery from an aesthetic procedure takes 2-3 weeks. However, complete healing is a slow process. Even after two months, the scar may still have a raised and/or reddish appearance. It may take a full year or two for the body to rebuild itself, producing collagen and reconfiguring the scar.

    Q: What should be done during the healing process?
    A:

    It is important to keep the area moist and clean. Your doctor may prescribe an antibiotic ointment such as Bactroban to avoid infection until the wound closes.

    Your sutures should be removed as early as possible to help minimize scar production.

    During recovery, it is important to maintain a healthy lifestyle, including proper nutrition and sufficient fluid intake. Drink at least eight glasses of water a day and avoid caffeine. Above all, do not smoke! Smoking impedes healing by shrinking blood vessels and reducing the amount of oxygen in your blood.

    Other things that can help the healing process:

    • For new incisions, a medical paper tape may be useful in alleviating tension on the skin. This can help the skin heal more quickly and prevent any raised scar tissue.
    • Silicone sheeting, such as ReJuveness, can be applied at the appropriate stage of post-operative healing. This material seals in moisture and protects the skin from harmful bacteria and debris.
    • After the incision site is closed and the sutures are removed, your surgeon may recommend massaging the scar with an ointment such as Kelo-cote, which may help level it.
    Q: If scars do occur, what can be done to help them fade/disappear?
    A:

    If visible scars remain, several options can help diminish their appearance:

    • Scar treatment gels and creams such as Kelo-cote and bioCorneum help soften and level raised scars as well as reduce redness. They can be used on new or old scars.
    • Dermabrasion, which involves removing the top layers of skin, can smooth and refresh the skin’s surface.
    • Steroids, administered topically or by injection, can decrease the redness and size of certain scars.
    • Laser treatments, done in conjunction with other treatments, can be used to smooth, flatten, or remove the abnormal color of a scar.
    • Fillers such as Juvederm, along with other treatments, may treat depressed or concave scars.
    Q: Any advice for someone who has undergone plastic surgery that left scars?
    A:

    If your scars are a year or more old, you may consider medical micropigmentation or scar revision surgery.

    Medical micropigmentation involves infusing hypo-allergenic pigments into the skin using computerized equipment. These pigments can fade, so many patients have touch ups done every twelve months.

    Surgical scar revision involves surgically removing the entire scar to create a less obvious scar that blends in with your skin tone and texture. This is often used in conjunction with steroid injections, which may continue for up to two years to maximize healing and decrease the chance of a noticeable scar.

    Q: Is there anything to be done to prep before the surgery?
    A:

    Yes. Sometimes abnormal scarring is related to low grade infections. An effective hexachlorophene wash (Hibiclens) around the surgery area for a day or two before surgery is helpful.

    If you are a smoker, it is imperative that you stop six weeks prior to surgery.