How can I minimize scarring from transition surgery?

Q: “What can I do to make the scars from my upcoming transition less noticeable?”

Answered by Dr. Ciro Martins, Board-Certified Dermatologist*

I’m glad you asked, for there is quite a lot you can do to minimize transition scarring. Gender reassignment often requires multiple surgeries to alter the appearance and function of existing sexual characteristics. These “top” and “bottom” procedures are all major surgeries that involve incisions and the inevitable scars can be upsetting. Fortunately, there are proactive changes you can make, as well as, many scar repair treatment options, to reduce the appearance of surgical scars and allow you to fully enjoy your new dream body.

How Scars Form

Scars are fibrous tissues that replace normal skin after an injury. They are a natural part of the body’s healing process. There are several different types of surgical scars including:

  • Cicatrix – flat and slightly off-color, usually fades over time
  • Hypertrophic scar – slightly raised along the incision, may fade with time
  • Keloid – significantly raised beyond the incision site and will not fade without treatment.
  • Contracture scar – occurs when the new skin becomes tighter and thicker than your skin, sometimes limiting movement.

The appearance of your surgical scars depends upon many unique factors. Skin tone and genetics play a role in how your scars form. People at greater risk for more significant scarring are those with darker skin tones and a family history of scarring. How you heal also depends upon your medical history, current physical condition, lifestyle habits, and your level of compliance with your pre-op and post-op instructions.

Before Surgery

Before surgery, there are many proactive lifestyle changes you can make to improve your surgical results and minimize scarring, including:

  • Eating a well-balanced, nutritious diet – high in protein, fiber, and antioxidant-rich fruits and vegetables, and minimal sugar to prevent inflammation – will give your body the nutrients and fuel it needs.
  • Taking micronutrient supplements – such as Vitamin C, Milk Thistle, Coenzyme Q10, Zinc, Probiotics, and IV Therapy.
  • Stop smoking at least 3 weeks prior to your surgery, for tobacco reduces the amount of oxygen that reaches the skin and can impede healing.
  • Avoid anything toxic to the liver – alcohol, acetaminophen and other select medicines – for about a month before surgery because you’ll need your liver to be as healthy as possible to help expel toxins from your anesthesia and pain medications.

After Surgery

After surgery, it is imperative to follow your surgeon’s recovery instructions exactly. Most likely you will be advised to:

  • Keep your incisions clean and covered.
  • Wear compression garments for supportive pressure.
  • Avoid any tension on the incision that could pull it apart, delay healing, and possibly increase the size of your scars.
  • Continue to eat well, drink a lot of water, and take micronutrient supplements.
  • Avoid tobacco and alcohol for as long as possible.
  • Protect your scars from sunlight for at least 12-18 months following surgery, for the sun’s ultraviolet rays can quickly make them more pronounced (hyperpigmentation).
  • Apply Silicone gel sheets as soon as the incision closes (about 10-14 days post-op) to keep it hydrated and soften the scar tissue.
  • Gently massage your scars to break down the bands of collagen that attach to underlying tissue.

After Healing

Scars can take up to twelve months to heal completely, so you need to be patient. Once they’ve healed, you may decide your scars need further intervention. Luckily, there are many treatment options that can help, including:

  • Injectables Dermal Fillers such as Juvederm or Restylane to fill in concave areas.
  • Dermaplaning/Microdermabrasion —Removes the top layers of skin and scar tissue.
  • Microneedling – Uses tiny fine needles that stimulate the production of healthy collagen to improve the scar’s tone and texture.
  • Laser Therapy – Removes layers of skin in targeted areas to improve a scar’s elasticity, texture, tone, and color to better match the surrounding skin.
  • Cortisone injections —A steroid injection that softens skin and helps to shrink hard scars.
  • Surgery —Surgical scar removal involves removing the scar and reattaching the skin; essentially a “do-over” for the healing process. Surgical scar revision doesn’t remove the scar completely; it adjusts the scar to reduce visibility by making it blend in more with your skin.

Your Medical Team

Different types of scars require different treatments. To ensure you receive the right treatment and care, it’s important to consult with a reputable board-certified physician. Successful scar repair requires a deep understanding of medical and aesthetic conditions, proper training, extensive experience, and advanced technological resources. Remember, treatment results appear gradually over time, and multiple treatments might be necessary. Patience and diligence are necessary as you strive to gain your desired appearance so you can finally enjoy the body you were meant to enjoy. Good Luck!

About Dr. Ciro Martins

Dr. Ciro Martins is a recognized leader in medical dermatology, infectious diseases of the skin, autoimmune skin disorders, tropical dermatology, and overall skin wellness. As a specialist in the prevention, diagnosis, and treatment of skin cancers, Dr. Martins has treated thousands of patients with compassionate, personalized care. Board-certified by the American Board of Dermatology and the Brazilian Society of Dermatology, Dr. Martins trained at both the University of Sao Paulo School of Medicine and the Johns Hopkins School of Medicine.

Schedule your private consultation today. 410.424.5842

About Belcara Health

Belcara Health is a unique, multidisciplinary practice offering Plastic Surgery, Dermatology, Ophthalmology, Wellness, and Skin & Laser services – all under one roof. Our world-class team of specialists collaborates to provide a continuum of care with integrated, personalized services and procedures designed to help people look and feel their best.

We are honored to serve the LGBTQ community. Based in Baltimore, Belcara Health was founded in 1996 and has grown to become a national leader in advanced medical and aesthetic services. Our standards for patient care are very high and we are proud of our reputation for providing outstanding care and unrivaled results. Learn more about how we might help you, your family and friends live happier, healthier, more vibrant lives – now, and for the years ahead.

*Originally published in Baltimore OUTLoud, Nov. 2019.




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