Healing Scars
Healing scars after any surgery is a frequently discussed topic for those of us who have been through it. The word scar derives from the Greek eskhara, scab. In the present day English language it can be both a noun and a verb.
- Noun – a mark left on the skin or within body tissue where a wound, burn, or sore has not healed completely and fibrous connective tissue has developed.
- Verb – a lasting effect of grief, fear, or other emotion left on a person’s character by a traumatic experience
Scar – Noun
The first definition, a noun, describes fibrous, connective tissue developing. When you think about it in those terms it implies building and getting stronger, fibrous/connective. I still have very young scars from the three surgeries that I have had this past year. The mastectomy scars were the first of those three surgeries. The scars were long, about a foot and a half combined, and deep. The tumor was removed by cutting two scar lines on either side of my breasts and lifting the tissue to remove the malignancies that lie beneath the skin. My breast surgeon was able to save my nipples but the line of scars that formed under what was once my breast mound would need help to soften after recovery. It would take weeks of post-surgical physical therapy. I would learn how to massage the scars deeply and gently stretch the skin to keep it pliable and ready for my reconstruction. This physical therapy also aided in restoring range of motion (ROM) in both arms.
Healing Scars: DIEP flap Phase 1
I would add to my scars at stage one of reconstruction. The new breast mounds would be made by performing DIEP flap surgery. More cutting, more scabs, more healing.
This is a picture of my abdominal scar just five days post surgery with drains still in place. My plastic surgeon (PS) ordered more physical therapy for this scar and the scars on my new breasts. My physical therapist would work her magic again by using ultra sound guided massage therapy to break down the connective tissue and keep it pliable for two reasons. First of all, I was preparing my skin for phase 2 of my reconstruction. Secondly, scars can become painful. There is a rebuilding process in scar healing and part of physical therapy is to guide the collagen fibers to align properly and not become deep and thick thus avoiding potentially painful scars from adhesion. My PS also removed old scar tissue that had built up in my left breast after receiving radiation twelve years ago.
Scar Revision: DIEP flap Phase 2
I had a good chuckle with my plastic surgeon the day before my phase 2 surgery. During phase 1 he had to place flaps from my tummy tissue on the underside of my breasts to facilitate the “real estate” needed to make new breasts. I kid you not; they were in the shape of a cowboy hat. Since I had my reconstructive surgery done in Texas I asked him if he saved his special “cowboy hat” template for his out of town patients to remember just where they had their procedure done. He chuckled and told me that those “cowboy hat” flaps were about to change and I was going to lose them. As I have stated many times, this man is a creative and skilled genius when it comes to breast reconstruction. The scar revision he performed for phase 2 was impressive. Those “cowboy hats” turned into small, well-placed flaps that would never be seen when wearing a blouse or swimsuit top. He removed the “dog-ears” at either end of my abdominal scars. I’m not sure what other magic he performed but in cleaning up those scars to heal and look more aesthetically pleasing he also made them less painful. He carefully used internal stitches and then covered them with a clear, liquid-type derma bond that formed a layer of protection while they were healing.
Scar – Verb
We cannot be put back together as good as new once we experience the emotional scars of cancer or any other traumatic event. As with physical scars, they are there for life. Some call them a daily reminder of what you have been through. Others have said they are a “badge of honor”, “score one for the tough guy”, “I have more scars than you do”.
How do you see your scars? What do they mean to you? How do your emotional scars relate to the physical? I keep a close eye on my physical scars and their healing process. I tend to my scars as I have been advised to by my surgeon. The physical healing is a mechanical, scientific process. Not so with the emotional scars.
Emotional Aspect of Healing Scars
I have friends who have had those traumatic events in their lives and their scars are not as hidden as mine are by my clothing. They must deal far more frequently than I with other peoples’ reaction to their scars. People might ask what happened or give them that awkward second glance. Having to explain those scars can become tiresome at best. People are naturally curious but don’t always know the polite thing to say when they see a person’s visible scars.
I spoke with a woman recently who is contemplating reconstruction and one of the things she was grappling with was having scars. I simply told her that there is no way around it. The reconstruction procedure I had will leave you with lifetime physical scars. They will heal. This picture was taken before I had phase 2 revision surgery and the difference is significant and the results are impressive when you look at the picture I inserted after phase 1 surgery. The additional red marks are just from my clothing. Focus on the horizontal abdominal scar. It is going to look even better in the weeks and months to come as I nurture all my scars back to a healthy state. I am grateful that I found a gifted and skilled plastic surgeon who knows how to carefully make and revise those scars to be as aesthetically pleasing as scars can be. It is something that we should speak to a plastic surgeon about before he proceeds with any surgery that will leave scars, whether visible or not. Scars have a life and process of their own.
Take Time to Heal
I hope that by sharing these pictures that you can visually see that in the hands of a well qualified, plastic surgeon your scars will heal properly and fade over time. Mine are still in the recovery phase and I will be diligent about tending to them.
My emotional scars will always be there but will also be have less impact on my life as they heal just like my physical scars. It is part of the new me after cancer. It is important to except the fact that those emotional scars are very much a part of you and need as much tending to as the physical scars. Tend to them. Do what it takes to make them better, to cause you less pain, and allow them to heal.