Best Plastic Surgery


Dr. Srinjoy Saha, India



Treating The Outside, Healing Deep Inside.



A Breakdown of the Best Scar Removal Treatments that are Safe and Effective.



An accomplished plastic surgeon will minimize your scars with advanced cosmetic microsurgery & scar rehabilitation therapy.


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What Are Scars?





Scars are a natural response of your body's healing process. It forms when the deeper skin layer is damaged. To repair it, your body forms new collagen, resulting in a scar. Mostly, the scars appear pale and flat. In young and dark-skinned people, the body may produce excessive collagen, resulting in keloid and hypertrophic scar. Following burns, scars may shorten, forming contractures, which restrict bodily movements.



How To Remove Scars?





A scar cannot be removed permanently. At best, the scar appearance can be improved upon to make it less visible. Cosmetic microsurgery, different surgical techniques, lasers, fillers, and fat grafting improve the appearance and severity of scarring. Scar rehabilitation is a novel way of minimising keloids and hypertrophic scars without removing them. Scar normalisation techniques streamline scar appearance.



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Post Burn Scar Contracture.





Thick scars may form over burnt areas that did not heal by themselves or after skin grafting within 2-3 weeks. They look ugly, itch constantly, and may cause loss of function of the involved part of the body. Size and severity of burn injury, depth thickness, and extent of scars determine the type of surgery best suited for that condition. Skin grafts, Full-thickness grafts, Skin flaps, Tissue expanders, Laser resurfacing, and Fractional laser treatment are different options from which treatment strategy is finalized.



Keloids and Hypertrophic Scars.





A scar is a part of the body's natural healing process. Often they shrink and fade away. But sometimes, they become large, raised, itchy, discolored, painful. This condition is called Hypertrophic Scar. If they continue to grow in size, involve surrounding normal body areas and become progressively itchy and painful, they have progressed into a Keloid. Keloids are very difficult to cure but can be controlled well with proper effort. Excision and reconstruction, Laser therapy, Biomaterials, Cryotherapy, Injectables, Silicone gel, Pressure garments are some of the different types of plastic surgery and adjuvant treatments available. Based on the type, size, site, and shape of the scar, each treatment plan is customized after knowing the patient's functional and aesthetic goals.



Scars Are Inevitable.





Scars occur in our bodies after any cut or injury. A scar is an essential component of the repair of injured tissues in human bodies. Scars are thus inevitable whenever there is damage to the skin, like in cuts and bruises. It occurs even after the incisions made during a surgery, even in cosmetic surgery. There are ways and means of minimizing this scar formation. The fine surgical skills of a surgeon play a vital role to minimize scar formation, so results will vary from surgeon to surgeon. Your own body reaction is also a big determinant of the final scar formation.



Best Techniques Improve Scars.





One question arises in the mind of most patients, and maybe yours too: "I understand that my body will heal with a scar, but I am not ready to accept any scars. Can you do something to erase all scars?" There are multiple factors that determine the answer, some of which are under our control, while some others are not. Best plastic surgeons like Dr. Srinjoy Saha take multiple steps to minimize scars with a high success rate. Scars can be improved upon gradually to make them imperceptible. There are many ways of minimizing or removing scars in a scientific, systematic, well-laid-out way.



Scar Formation Can Vary Widely.





Scarring after surgery can vary enormously from person to person. Employing the same surgical technique, one person may have virtually no visible scars. Another person may have some visible scars that would fade over time. While a third person who is predisposed to bad scar formation can have noticeable, ugly scars after complete healing. These scar results do not happen because of differing body response mechanisms. Certain skillful surgical techniques minimize scar problems and integrating them during your surgery will benefit you in producing the best possible scars.



Realistic Expectations are Better.





If you are extremely concerned about your final scars, you will need to follow proper aftercare as detailed above. Various methods of scar betterment are available, some of which are beneficial and some are not. The goal of scar betterment is the improvement of the final scar appearance, hopefully making it imperceptible; and not removal. Utilizing advanced scientific Scar Protocol during your post-operative period will help you achieve great results during your healing period, and it is recommended that you utilize it for the best results in final scar appearance.



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What Factors Determine Your Scar Formation?



Skin Type.





Fitzpatrick skin type I have a greater tendency for skin irritation and burns after sunlight exposure. Scar formation is less in skin types I and II. On the opposite end, Fitzpatrick skin type VI has a greater tendency towards hyperpigmentation and tanning following exposure to sunlight. Types V and VI are bad scar formers. Most Indians belong to Fitzpatrick skin types V and sometimes VI, the two types associated with developing pathological scars. Fair-skinned Indians are skin type IV, who also scar easily.



Genetics.





Does your immediate family consisting of your father, mother, brother(s) and sister(s) have a tendency towards scarring badly and heavily? If they do, you may be at risk of forming a bad scar as well. If they do not, it may be assumed that you may not form a bad scar, but there are absolutely no guarantees about it. Genetic mutations are known to happen, and some people have been found to scar badly even when they do not have any bad scar formers in their immediate family.



Age.





People aged 15 - 55 years usually have more noticeable scars. In early childhood, scars tend to heal better than in adults. In older age with lax skin and tissues, scars tend to get concealed within the wrinkles and creases and be less obvious than in younger skin. Skin healing is worse in advanced age, however. Skin becomes thinner, less elastic, forms less collagen as you age older. Sun exposure, exposure to the environment, smoking, and lifestyle issues also play a role in worsening skin healing with advanced age.



Race.





Some races are more likely to form bad scars than others. People of African descent are known to be more prone to developing keloids and hypertrophic scars, which consist of excessive overgrowth of scar tissues at the site of injury. In India, similar tendencies are found in different tribal populations.



Personal Factors.





Some people are blessed with genes that make them heal quickly and with minimum scar visibility or formation. If you are one of them, a well-done surgery with appropriate wound closure techniques will be sufficient to result in imperceptible scars. On the other hand, some of you will be more prone to forming bad scars no matter what.



Underlying Diseases.





Patients who suffer from diseases like diabetes, hypothyroidism, and connective tissue disorders heal badly and slowly. They need more precautionary measures than just good surgical closure for better results. In some, even after all treatments and precautions, results may not turn out to be entirely satisfying.



Best Plastic Surgery Techniques to Minimise Scar Formation.



Reducing Tension.





Reducing tension on the wound edges is extremely important in preventing bad scar formation. Creating and advancing flaps, progressive tension closure techniques are amongst the different methods used during your surgery to produce better scars.



Wound Edge Eversion.





Dr. Srinjoy Saha regularly performs this technique for patients desiring good scar over their faces, with a very high degree of success. Eversion of wound edges has been found to achieve a fine, flat scar in multiple split-scar randomized controlled trials.



Cosmetic Microsurgery.





Best results are produced after employing microsurgical principles for skin closure, especially over the face. Under high magnification, micro surgery instruments and extremely fine sutures are utilized to co-apt the skin edges without tension.



Hiding Incisions.





Incisions placed within naturally-occurring wrinkles and creases of your body result in a good final scar. Better final scars appear when placed within relaxed skin tension lines (RSTL) over your face and body. Z-plasty breaks and realigns scars going against RSTL.



Scar Care.





Avoiding wound infection over incisions, regular cleaning and dressings, proper scar massage twice daily, silicone gel sheet with compression, and avoiding scar pigmentation with sunscreen application - are important elements of scar aftercare that you need to ensure.



Post-op Scar Protocol.





An advanced, scientifically-validated protocol combining different principles of tissue engineering, medicines, and laser therapy produces excellent results for bettering existing scars. Better results occur when it's started within a few weeks of scar formation.



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6 Ways To Get BETTER SCARS After Your Surgery.



Take Adequate Rest.





Adequate rest to the healing part is vital for proper wound healing. Exhaustion slows down healing. If you are asked to take a rest for a few weeks, please follow that advice. Avoid thinking that you know better while ignoring the doctor's advice and following your own impulses, whims, and fancies.



Avoid Stress On Incisions.





Any type of stress on your incision line that stretches or puts tension to that area should be avoided at all costs. Stress on wound margins pulls the incision apart, delays healing, stretches scar, and leads to hypertrophic scar formation. Caution for the first 3 months is helpful.



Take Proper Wound Care.





Proper wound care is the single most important determinant to good wound healing and to prevent bad scar formation. Regular cleaning and proper dressing to care for the wound, avoiding injury to the incision site, preventing infection, and other general incision care techniques are essential.



Treat Any Wound Infections Quickly.





Signs of wound infection include (1) expanding redness around the wound, (2) yellowish or greenish colored pus or cloudy wound drainage, (3) red streak marks spreading out from the wound edges, (4) increased swelling, pain, or tenderness around the wound, (5) fever.



Treat All Underlying Diseases.





Many underlying illnesses slow and impair healing. Diabetes, Thyroid problems, Connective tissue disorders, Autoimmune disorders, etc are notorious to delay wound healing, open up wounds and cause poor scars. Diagnosing and treating them before your surgery is vital.



Avoid Sunlight Exposure For Few Months.





Healing scars are extremely sensitive to brownish discoloration along the edges following exposure to Sunlight and any form of Ultraviolet light. Applying a good sunscreen with a high sun protection factor of SPF 30-50 and adequately cover healing scars will ultimately benefit you.


Dr. SRINJOY SAHA | FRCS, FACS, MCh, MS



Dr Srinjoy Saha - Top Plastic Surgeon in India.



Apollo Gleneagles Hospital, 58 Canal Circular Road, Kolkata.


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