1. What should I expect when I go home after surgery?
You may experience pain once the anesthesia wears off. This typically occurs 90 min to 3 hours after the procedure. The type and severity of the pain depends on the location of your surgery and the tension of the wound. Expect a “headache” if your surgery was on your forehead or scalp.
Avoid NSAIDS such as ibuprofen, Aleve, or aspirin for 48 hours after surgery and take 2 extra strength Tylenol every 6 hours for pain. If your doctor gave you a narcotic pain killer, remember to take it with food and avoid taking Tylenol at the same time.
You can also ice the wound on top of your dressing for 10-15 minutes every hour. Elevation of the hands or feet for extremity surgeries will help alleviate pain and swelling.
Please follow the instructions given to you regarding postoperative care. You can find these instructions on this website.
2. Will I have a bruise or swelling?
You may develop a bruise around or inferior to the incision depending on the location and your coagulation status. Patients taking blood thinners will more likely develop a bruise. The bruise and swelling will develop where gravity takes the fluid. For example, patients who had surgery on the forehead or frontal scalp may develop swelling and a bruise around the eyelid(s) 1-2 days after the surgery. This will resolve over the next week. Please elevate your hand or foot if your surgery was located on your extremity. This will prevent swelling in your fingers or toes.
3. Why does my scar look bumpy?
The scar was sutured as a “ridge” so it will flatten out as the scar contracts during healing. This will avoid having a “dent” in the skin. Some areas of the incision may be “bumpier” then others due to fluid that becomes entrapped in between sutures. This will resolve once the sutures are removed. The whole scar will flatten out over the next 3 months.
4. How will the appearance of my scar change after surgery?
As described above, the scar will slowly flatten out to become less apparent. The “pinkness” will fade as well but not entirely. Some patients may develop small twisted blood vessels called telangiectasias around the scar depending on the location of the scar. The face, especially, the nose has a tendency to form these little vessels. These will fade over the next year and can be removed easily with a laser.
You may experience a suture reaction under the skin during this time. This reaction appears as a little red pimple under the skin along the incision line. Your body is treating the buried suture as a foreign body and trying to get rid of it and may even “spit” the suture out. Sometimes you can see a little piece of suture or string sticking out of the skin. Warm compresses over the “pimples” or bumps will help. You can do this 3 times a day for 5 minutes until the bump resolves. You can also trim the spitting suture with small scissors or see your doctor to have it removed.
You may also experience some numbness around the incision. If the surgery was on your forehead, you may experience some numbness on the scalp superior to the incision.
The scar should be completely flat and only a little pink by now. Any “bumps” that persist can be firmly massaged against the underlying bone daily. Numbness will start to resolve at this point and you may feel some “pins and needles” or tingling in the area.
Numbness will continue to improve although it may not go away entirely. The scar is maturing now into its permanent appearance. Depending on the location, you may not be able to see it at all or you may only see a thin white line. Everyone heals differently, some quicker than others. Also, different areas of the body heal better than others. The legs remain discolored longer than other areas of the body. Scars on the back and around joints may spread and widen depending on your level of activity.
If you are not happy with the healing of your scar (for example, you massaged a bump and it did not resolve or the scar stayed pink or red), please see Dr. Litani for scar revision. This is usually a minor and quick procedure which can perfect the appearance of your scar.
5. What should I do if I form a hypertrophic scar or keloid (thickened pink-red scar)?
Some areas of the body tend to form thickened scars or keloids more than other areas of the body (for example, the chest). Please see your doctor who can treat the scar with an injection or a laser in order to flatten it.
6. Why do I have pimple or scab forming in the incision line?
You are having a reaction to the buried suture. Please see question 4.