Surgical scars: when to start caring for them, and with what

Liposuction and fat transfer leave small entry points where the cannula (a thin, blunt tube) goes in and out. They’re only a few millimeters, but it’s natural to care about a scar that stays on your body. Minimizing scars starts during surgery, with protecting and closing the entry points, and after that it’s up to care in the months after the wound heals. What does research say about that care?

Silicone has been studied the most. Scar management recommendations compiled in 2014 by physicians from several countries advise that, for wounds at risk of scarring, silicone gel or sheets be used for at least 1 month, for 12 hours or more a day, once the wound has fully healed. They said wearing it all day is best, if possible. On the face, in areas that move a lot, or in hot and humid weather, they considered gel easier to use than sheets. For a scar that is already red and raised, they advised trying silicone for 2 months and adding injection treatment if it doesn’t improve. Practical guidelines issued the same year by 24 physicians also named silicone as the first choice.

That doesn’t mean the evidence is solid. A 2013 Cochrane review (20 clinical trials, 873 people) found that silicone sheets reduced hypertrophic (raised) scars in people prone to them and improved the thickness and color of existing scars. But it concluded that the studies were of low quality with a high risk of bias, so the evidence of benefit is weak. So it’s more accurate to see silicone not as “a product that will definitely make scars disappear,” but as “a method with enough evidence to be worth trying.”

There isn’t much research on sunlight, but the recommendation is clear. A clinical trial found that scars exposed to sunlight after surgery were more noticeable, and the recommendations above state that ideally, scars should not be exposed to sunlight during recovery. Simply covering them with clothing or applying sunscreen carefully helps reduce darkening of the scar.

Timing matters too. The recommendations say not to start scar treatment until the skin surface has fully closed and the wound has stabilized. Applying a product to a wound that hasn’t healed can actually make it worse. That’s why I decide when you can start silicone after looking at the wound myself. It’s also why I ask you to check with the clinic before using it.

Scars usually turn red and then fade over several months. If you’ve had a scar become very raised in the past, please be sure to mention it at your consultation before surgery. For people with that history, I plan scar care differently from the start.