Breast reconstruction for mastectomy involves the healing of mastectomy incisions and often additional incisions from abdominal donor sites. Patients will often ask what to do about their incisions to facilitate healing. In general, we instruct patients to avoid creams or ointments on the incisions as well as any hydrogen peroxide or rubbing alcohol. After six weeks once all the incisions are closed, healed, and there are no signs of delayed healing it is ok for patients to place silicone sheets on the incisions.
Three days after surgery your body starts to produce collagen to heal the incisions. This collagen production by the body becomes maximal until week 6-8. During this time the healing incisions become thick, firm, and often red. This thickening beneath the skin is the body’s normal healing process. After 6-8 weeks when the incisions are closed and healed, the body starts to remodel the collagen present in the scars and the scars begin to soften. This remodeling or “softening” process can continue for one year to two years after surgery. It is important during this healing and maturation of the scars that additional trauma and inflammation is not directed to the scars as this may prolong and increase the inflammatory phase of wound healing and lead to more thick, aggressive scars.
The photo displays a bilateral DIEP flap breast reconstruction performed over 10 years ago. The scars have faded and are no longer red. The scars are flat, pale, and not raised.
Examining the photograph of the early post-operative result, approximately 3 months post-operatively. At the 3-month post-operative point the incisions are red. There is a palpable fullness beneath the incision, but the incision is not raised or keloid. Waiting appropriately for the scars to heal and fade on their own is often the best course of action. The use of silicone sheets at the six-week mark for approximately 3 months can be helpful for mechanically remodeling of the scar.
