What you need to know about healing and cosmetic procedure.

In today’s blog we will talk about healing and some of the factors that influence healing after a procedure. Whether you are planning something small like ear lobe repair, its important to understand what happens after the procedure is finished.

1.

Some basic biology.

All body tissues are made up of complex arrangements of a microscopic cells joined together by a supporting scaffold. When we perform procedure, we remove an area of tissue and join the remaining edges together using stitches, staples, or glue.  Between these newly opposed edges is the area that will become a scar. The way in which the healing process proceeds will determine the size of this scar. The normal process of healing consists of three phases. The first is “inflammation”, a phase lasting from seconds to days. This phase is where cells talk to each other to let our body know injury has occurred and start the healing process. The second phase is the “proliferation” phase. This happens over the next few days to weeks. Here, cells that help with the growth and repair of tissues are working overtime to lay down a new scaffold to join the two edges together. Finally, there is a “maturation” stage, lasting usually 2-3 months and up to a year, that lets this new scaffold remodel in the strongest way possible.

2.

Why is this important?

Surgical wounds that heal normally will usually leave a small scar that continues to fade over time. Abnormal healing can occur due to many factors, and these delays in the healing process contribute to the final appearance of the scar. Infection is one factor that contributes to poor healing. Despite best efforts in patient preparation and using “sterile” operating technique, infection may occur and impact a healing wound.  Intrinsic patient factors, such as skin type, high levels of stress, vitamin deficiency, or underlying disease like diabetes may also impact the way in which a wound heals. Extrinsic patient factors may also alter the healing process. Smoking is one well know cause of delayed wound healing as the healing tissue is exposed to toxins as well as being starved of oxygen relative to a non-smoker’s wound. Other medications may also impact wound healing, especially those used for auto-immune conditions, like rheumatoid arthritis. Finally, repeated movement across a healing wound site will beak down the developing scaffold and slows the healing process.

3. How patients can optimise their healing.

Before a patient has a procedure, it is most important that they be in the best possible health. This includes both physical and mental health. Leading up to a procedure it is important more than ever to ensure a good diet including a good mixture of fruits, vegetables, and lean meats. This combination of foods will provide all the required vitamins for optimal wound healing without the need for supplementation. Patients with underlying medical conditions should be reviewed by their general practitioner to ensure their medication regime is optimal in the setting of the upcoming procedure. Smokers are advised to cease, or at the very least reduce, the intake of tobacco. Finally, stress and lack of sleep can significantly delay wound healing. A 2006 article published in “Neuroimmunolomodulation” showed delayed healing of 25-40 percent in patients who had minor procedures whilst under a period of stress. When deciding when to have a procedure we ask patents to consider this. If stress, anxiety, or depression are active in your life we recommend discussing this with your GP and addressing these issues before we go forwards with any treatments. Following from this, we also recommend ensuring you have plenty of recovery time after procedure as all surgeries come with some level of discomfort. Again, it is important to let allow yourself some time to relax and recover to get the best results. This includes a period of no exercise, as wounds need stability to heal properly. Often the best post-operative prescription is “Netflix and a cup of tea, repeat as necessary.”

4. When things go wrong.

Every procedure comes with risks. Elective procedures are no different. Sometimes infection may occur, or a wound may need to be re-opened due to bleeding. What is important here is to recognise that although these delays to healing may slightly increase the initial appearance of a scar, becoming very worried about this is not in your best interest. We will work to address the problem as your medical team, and sometimes this means we will ask you to attend for closer follow up so we can keep an eye on your progress. Your role is to relax, eat well, stay hydrated, and allow the wound time to settle. After wounds are healed, we have options to improve the final scar with various methods including ointments, laser treatments, and even revision in some cases. Also to note, is that the appearance of a wound in the first few weeks post operatively may not indicate the final result of the wound. People mount different inflammatory responses to procedure, so worrying over this appearance should be avoided. If reassurance is required, we are always available to review any of our patients for piece of mind.

Hopefully this helps when it comes to getting prepared for an upcoming procedure. Please always discuss any concerns with us leading up to your procedure, be it in your consultation, pre-operative phone review, or any other time via email to our Subiaco clinic.