How to Reduce Scarring After Bunion Surgery
Immediate post-operative image of patient with cosmetic mini closure.
After a surgery to correct your bunion, obviously you will have some incisions that need to heal. Lapiplasty® will results in several incisions after surgery. Pictured here is the mini incisional approach, with shorter scars than traditional bunion surgery. The length of the primary incision is less than 4 cm, think the width of two or three fingers depending on the size of your hand.
Incisions will be closed in a cosmetic fashion after surgery, meaning that sutures with be under the skin. This means no painful or tedious suture removal after surgery. By utilizing this approach, it prevents the look of a “railroad” track scar from traditional closure techniques employed by most foot surgeons. Steri strips will be visible over the incision, which are small pieces of tape that are like butterfly bandages and further strengthen the incision. Once the sutures have been removed, steri strips will be left in place and can be removed in 3-4 days by patient at home.
After your sutures and steri strips have been removed, the time to begin scar care starts immediately for best outcomes. You have several options for scar care including topical over the counter medication, vitamin E oil from Vitamin E capsules, gel scar care sheets, essential oils, and in special cases prescription medication. I recommend over the counter Mederma® applied three times daily, rubbed into incision until the moisture and any stickiness disappears. When rubbing scar cream or oil into incision, apply against the line of the incision (perpendicular). This is called cross fiber massage and allows the collagen fibers that are responsible for scar healing to align properly. If sun will possibly be on your incision then a SPF version is best. The sun will have a negative effect on scar appearance.
12 week post-operative visit of patient with cosmetic closure, scars are barely visible.
Vitamin E oil is also a popular choice as well as gel scar sheets applied over site. Scar cream, or oil should not be rubbed into any raw areas of skin or open wounds. I recommend applying scar cream 3 times daily for the first 6-8 weeks after surgery and then daily after that for up to a year to reduce scar appearance if you wish, but most patients scar is not very visible if applied only during the immediate post-op period.
If you know that you develop a condition called hypertrophic (thicker scars) or worse, keloid scars(scars that grow beyond surgical incision) Dr. Steinke will use a specialized closure technique that allows reduction in the formation of abnormal scars. Injection of steroid medication under the surgical incision at surgery and during recovery if needed, can also reduce the proliferation of this abnormal scar tissue. Prescription scar medication may also be prescribed.
Remember even though bunion surgery is performed to reduce pain and eliminate limitations for the patient, post-operative appearance does matter. Once the incision is closed in the operating room by Dr. Steinke, you need to follow these simple scar care techniques to get the best possible outcome we all want to achieve.
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