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Surgical scars

Even the most necessary and effective surgical procedures can lead to the development of an ugly scar. A certain degree of scarring in inevitable. Moreover, the surgeon's skill level often doesn't even matter, some patients just have easily scarring skin.

The post-operative scar does not look good. What can be done?

You should certainly go to a consultation. I, for instance, like doing consultations on scar removal BEFORE the surgery itself (yes, a scar removal consultation before the scar is formed), and I am seeing more and more of these patients. For example, patients preparing for plastic surgery are often already thinking about how to avoid ugly scars.

If the surgery has already taken place, the best time to examine the scar and get initial recommendations is immediately after the sutures have been removed. But of course, I work with all kinds of scars. We can even remove scars that are as old as the patient themselves.

What are the types of post-operative scars?

Leaving aside complex pathophysiological international medical classifications and expressing myself in simpler language that patients can understand, there are three, more specifically four, main types of post-operative scars:

  1. Normotrophic postoperative scars match the size of the incision and their surface is even with the surrounding skin

  2. Hypotrophic scars (below skin surface)

  3. Hypertrophic scars (above skin surface)

  4. And finally, the most horrific of post-operative scars: the keloid – a type of scar that is much larger than the initial lesion, extending above the surrounding skin, usually in bright red colours.

Each type of post-operative scar is treated differently.

Post-operative scars are also classified by location and type of surgery. In my experience, the most common types are:

  1. Post-operative scars on the breasts (scars after breast augmentation/reduction, rhinoplasty, breast lift, etc.)

  2. Scars after various abdominal surgeries or abdominoplasties

  3. Scars after heart surgery (or other chest surgeries)

  4. Scars after rhinoplasty

  5. Scars after surgical removal of moles

  6. Scars after blepharoplasty

  7. Scars after other plastic surgeries

  8. Scars after a caesarean section

  9. Etc.

Depending on the location of the scar, we need to consider the thickness of the skin, subcutaneous adipose tissue and other underlying structures when planning treatment. The type of treatment also depends on scar localisation.

Fresh surgical scar. Two minor combined laser procedures based on Dr Uskov's protocol. The earlier you start, the better and quicker the outcome.

But that's not all. Imagine that each of these different scars has three stages, or maturation phases:

  1. Inflammatory

  2. Proliferative

  3. Maturation phase

It turns out that the treatment of scars also depends on its specific maturation phase.

haavaprotsessi faasid Dr Uskov
Pretty complicated?

It should by now be very clear that the treatment of post-operative scars is quite complicated, and there simply isn't a universal solution. There is no universal procedure for the removal of scars after surgery. And, if we fail to consider the type of scar and the phase of its formation, we can easily end up with a worse complication than the previous one, or even a new scar.


In addition, we must also consider the patient's individual characteristics: age, sex, scar history, co-morbidities, scar location, etc.

Video: post-operative scar in the navel area

What are the methods for treating post-operative scars?


There are many methods for treating post-operative scars. And that is very positive, because we have to combine these methods to achieve the best possible outcome. A brief list:

  1. Surgical methods (re-excision)

  2. A very wide variety of injections – from hormonal drugs (such as Kenalog) to 5-FU, COX-2, fillers, botulinum toxin, etc.

  3. A variety of creams, both relatively effective and completely ineffective, and even ones that haven't passed a single clinical trial

  4. Silicone patches

  5. Compression therapy

  6. RF therapy

  7. Transplanting your own hair into scar tissue (I myself was surprised to discover this study, but the recent method is promising. The study was published in early 2023)

  8. Photodynamic therapy

  9. IPL technique

  10. Laser methods:

  • Administering drugs into the scar using a laser

  • Fractional non-ablative lasers

  • Fractional ablative lasers

  • Non-fractional non-ablative lasers

  • Non-fractional ablative lasers

  • Photoacoustic lasers

Scar after mole removal
Arm pärast sünnimärgi eemaldamist
Scars after a caesarean section
Keisri lõikus
Scars after a rhinoplasty
Treatment of a blepharoplasty scar
Which scar removal method should you choose?

Frankly, the patient doesn't really have a choice in the matter, and it could even be harmful if they did. The selection of the method and their combinations is the healthcare specialist's responsibility.


I, for example, usually select one of the lasers as the primary method of treatment, but the accompanying methods can vary quite a lot. Moreover, the methods often change over the course of treatment depending on the response of the tissues.


The aim of post-operative scar treatment is to reduce the scar's prominence, make it more similar to the surrounding skin, even out its surface and change its texture. In most cases, post-operative scar treatment requires a course of treatment rather than a single procedure.

Abdominoplasty scar removal is often combined with the removal of stretch marks. This is feasible and comfortable for patients.


Any surgery can end up causing unsightly scarring. In some cases, this is completely unpredictable, and the post-operative scar may not get worse immediately, but, for example, half a year after the surgery.


In this article, I aimed to outline just how diverse post-operative scars and the methods used to treat them are.


If you are not satisfied with the outcome of a recent or older surgery, the first step is not to independently consult Dr Google, trying to find the most modern and effective method. The only genuine first step is a face-to-face consultation with an experienced specialist. The doctor/specialist will examine you, perform simpler examinations, if necessary, and come up with a personalised treatment plan that is best suited to your specific situation.

Dr Alexander Uskov



Dr Alexander Uskov MD PhD

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