Scar Healing: Post DIEP flap Surgery

Scars, scar healing, and scar therapy  after breast reconstruction surgery is a frequent topic of discussion on DiepCJourney support group page. I can share with you what I have learned about these topics after phase 1 & 2 of my DIEP flap surgeries.

What Forms the Scar?

You may have heard of collagen. Collagen is a structural protein occurring in our bodies. Collagen goes to work and is produced by your body, in simplest form, after skin is disrupted through a surgical incision. It repairs and heals the wound because of its fibrous, connective properties. It is what forms the scar when your body goes through its natural healing process.

Healing is Individual but Maintaining Health is Important!

We are all unique and individual when it comes to healing. Your skin color, genetics, and overall health are important factors in the individual outcomes and results in post-surgical healing. What I will say with resounding importance; smoking is detrimental to any type of surgery and healing. Your body needs oxygen to repair after surgery. If you are considering breast reconstruction surgery it is time to quit.  You can ask your plastic surgeon about a smoking cessation program.

Questions and Answers

Here are the common questions and topics of discussion from women who have had breast reconstruction surgery.

• Should I be massaging my scars?
• What can I do to minimize pain and discomfort of scars after phase 1 of DIEP flap breast reconstruction?
• Should I be using a cream or lotion on my scars?

Here are some tips I can contribute to the discussion based on my own experience:

• It is essential you discuss all scar therapy with your plastic surgeon (PS).  There are varying recommendations from plastic surgeons regarding scar healing so the overriding message here, start the discussion, ask the questions and understand the reason behind your surgeon’s protocol.
• If your scars become painful, ask your plastic surgeon about physical therapy. They can help you find a qualified physical therapist. Ask for a prescription for physical therapy. The cost may be covered by insurance. This method can help soften and break down the collagen. Fair warning: The manual massage used on your scars can be an uncomfortable experience. My physical therapist used to tell me that she could literally feel a “snap” in some of the connective tissue as she worked to break it down. This can be a painful experience depending on your pain tolerance so communicate this to your PT as they are massaging. Let them know your comfort level. I used to cringe at times when this process was taking place but I always left feeling much better and my scars less painful when I left her office.
• It is imperative all wound healing is complete before you apply any creams or lotions to your scars. Ask your plastic surgeon what they recommend. I do know vitamin C is an important component of scar healing. I have been using a product called InviCible Scars. There are many products on the market.  Ask your plastic surgeon for a recommendation.  This is one I chose.  I personally like the emollient nature of the cream and have truly noticed the fading of my scars with regular use.
• I did not start using InviCible Scars until after phase 2. Again, my experience but you can speak to your own plastic surgeon about products. A skilled plastic surgeon should be an expert and be well-versed in the life, structure, and healing process of scars. Look at their credentials. My plastic surgeon did a fellowship in burn research at a burn hospital for children, a gold star in my books for knowledge of scars and healing.
• Between phase 1 & phase 2 of DIEP flap breast reconstruction it is important to keep the skin pliable. When your surgeon does the fat grafting in phase 2 you do not want the skin in the breast area to adhere to the chest wall. I was given instructions by my physical therapist to gently pull upward with a flat hand, up and away on my chest tissue (as if toward my chin) to keep this area prepared and ready to receive the fat grafting for phase 2. She also did this same movement after my bilateral mastectomy. I had a delayed DIEP flap and she would smile and tell me, “Let’s get this area nice and soft and ready to receive the new flap.” I believe it was very beneficial.

I hope this answers some questions on scar healing for post DIEPflap surgery. I am always inspired by inquiries about various breast reconstruction questions and topics.  I will continue to share information I research and give you an inside look into my own experience. Seek experience from those of us who have “walked the walk” but I emphasize, any decisions regarding healing and therapy after surgery should be made with your healthcare provider.

Thank you always for inspiring me to write and share topics important to us all!

Disclaimer

References made to my surgical group, surgeon and healthcare team are made because they are aligned with my values and met my criterion after I did research of their practices and success rates. Any other healthcare provider that displays the same skill, compassion education and outreach to patients will be given consideration and recognition on this website.  The information contained on this website is not a substitute for or should be construed as medical advice. Please consult a licensed physician for medical advice.