No plastic surgeon can do surgery without a scar.
I know. Shocking the “doctors” on shows like Nip Tuck and every soap opera out there can fix a major accident with not a single scar, but real doctors cannot. In the real world, anytime you cut through the skin there will be a scar.
Our goal is to make that scar as fine, hair lined, tiny, well placed, and invisible as possible. But even a scar which will be a good scar (and fade to nothingness) starts as a scar you can see. I show scars when they are new. Most of the photos on my website are of scars at 6-8 weeks. On some surgeries, like eyelifts or breast augmentations, these scars are almost invisible quickly. Why? Breast augs and eyelifts have small scars, which are hidden and under no tension.
The common surgeries I do with larger scars are breast lifts and breast reductions (both of which I use a shorter, lollipop scar) and tummy tucks. You may be thinking, good heavens woman, why would you show those scars?!? Why are you not like the other plastic surgeons who only show scars at a year when they have faded or have every tummy tuck scar hidden under underwear? I could be cheeky and say, I am not like other plastic surgeons. But the true answer is you pay a price for surgery. I feel strongly you need to know that price, or I guess I should say potential price. I expect most of my patients will have scars which fade well. I don’t have many issues with ugly raised scars, keloids, etc. But I do have some patients who don’t scar well….usually it is a part of the scar…and for their surgery that patient paid a bigger price.
When you lift your breasts so they don’t hang to your knees after breast feeding three kids, the price you pay for cute perkier breasts is a scar. Many years ago I converted from the inferior pedicle technique, where we had a large anchor scar (where it is like the lollipop WITH an additional scar running the entire length and position of an underwire) to the vertical technique. Why? It shapes and holds better, and it is a smaller scar on the skin. If you are trying to limit a scar, why not go all the way and do the cute little donut lift where the scar only goes around the areola? (Excellent question from my educated Bay Area crowd…) That procedure is fraught with issues, and the scar though smaller frequently wrinkles, elevates, and bunches. A larger flat hairline scar is less noticable than a smaller wrinkly one.
Tummy tucks are a great operation to tighten the muscles and get rid of the loose, stretch-marked, muffin top skin, but the price you pay is a scar. Again, particularly in my fair skinned patients, I expect the final scar will be a hairline almost invisible scar. But what if it isn’t? My Bay Area patient base is very well educated. We had our children at older ages, so many of us got used to having a fit, healthy, tighter body. The changes after pregnancy can be tough. When you were hit hard by pregnancy, to get your muscles and skin tight again with a tummy tuck, you need to be okay with the scar. I find the patients who focus on the other changes- the flatter tummy, waist definition, tight skin, no stretch marks, smaller size- will be happy. The patients who are really bothered by the scar have a lower “price” they are willing to pay. I advise these patients to take a black sharpie marker and draw the scar on their belly. Wear underwear, your swimsuit, low rider jeans. If you had a tummy tuck and you were one of the few who did not heal well, would you be okay?
Here may be a place where being a female plastic surgeon who has had kids, pregnancies, and (eek) looser belly muscles and (sigh) looser skin, here may be a place where I am different in how I advise my patients. I watched my body change. I knew it was coming. I wanted these children more than anything. But my body will never be the same. Every person has what price they are willing to pay for perkier-lifted-firmer breasts or a flatter-tighter-waist-defined belly. What amount of risk? sensory change? scar? I can sense when I have a patient who has a low price they are willing to pay. They need a surgery to go perfectly and scarlessly or they will regret it. For these patients I advise them what you have now sucks, but it is G-d given. You earned it with your kids. Do you want to do this?
So I show scars. I show them when they are new and red and visible. The patients who can see these and go forward will be happy. The ones who can’t are usually the ones who had too low of a price and should stick with what they have.
Please keep in mind: subjects covered in this blog and certain tips and advice are not substitutes for professional medical advice. This blog is for general informational purposes only. If you are considering plastic surgery, reconstructive surgery, or cosmetic enhancement, you should always consult with a board-certified plastic surgeon and/or your general practitioner in-person for professional medical advice.
If you think you may have a medical emergency, call your doctor or (in the United States) 911 immediately. Always seek the advice of your doctor before starting or changing treatment.
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