Looking after yourself
Caring For Your Surgical Scars Following Breast Reconstruction
Please note: This information on scar management advice has been produced for the patients of Southmead Hospital, Bristol. This must not override any advice given by your own breast reconstruction or dressings nurse.
Following your breast surgery it is important to continue to keep the Micropore tape over your scars for up to 6 weeks. The pressure of the tape over the scar will help to reduce tension and support the healing wound – this will help reduce the risk of developing problematic scarring and improves surgical scar healing. The tape will need to be removed once a week and new tape reapplied. You can shower with the tape on and use a hairdryer on a cool settling to dry afterwards. Reapply the tape if it comes away from the skin.
DO NOT REMOVE the tape daily, as this will cause the skin to lose the top layers of skins cells and hinder the healing process.
After 6 weeks you may start moisturising and massaging your surgical scars with a non-perfumed moisturiser or silicone gel, which helps soften and hydrate the scar tissue. Your breast and abdominal scars may remain pink and change colour with different temperatures, e.g. when you are hot they will appear red and when you are cold they will look purple. This is normal and will gradually fade over time. How your scar heals will be determined by many different factors, such as; poor diet, infection, past history of radiotherapy/chemotherapy, along with your genetic tendency to scar.
If your scar starts to become firm, red, raised and itchy; this may be the start of Hypertrophic scarring which may develop in healed skin within the first three months after surgery. See the pictures below:
Photos courtesy of Crawford Healthcare
If your scarring is giving you concerns, please contact the Breast Reconstruction nurses for advice. You may need to be referred to our Scar Management Team at Southmead Hospital for treatment. Non-surgical treatment can be used to help with the texture and colour, these include; moisturising and massage, silicone gels/sprays, silicone dressing and pressure garments. It is important to remember that scarring can take up to two years to fully settle and some people will need treatment for this length of time.
Scarring should also be protected from sun exposure unit the scar has fully matured (become pale and inactive) this is around 2 years. A high factor sunscreen of SPF 50+ should be used to maintain protection from UVA and UVB light.
Tattooing Over Surgical Scars
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Some patients decide to disguise their abdominal scar by having a tattoo. If you are considering this option you need to ensure that the scar is completely healed. The healing process takes up to 18 months to heal, therefore tattooing must not be undertaken before this time. Tattooing won’t change the texture and it won’t erase the scar.
If you do decide to get a tattoo, make sure that the tattooist is experienced and has done tattoo art for people with similar scars in the past. Ensure that you ask to see photos of their work covering up the scars before booking up your tattoo. It is important to note that the scar may not take the ink, therefore, find out if the price of the tattoo covers all subsequent visits.
Camouflage creams can be applied to conceal or reduce the noticeability scars. The creams and powders are available in a wide range of shades, which are matched to your skin tone. The products have been clinically tested for skin sensitivity. They are not the same as ordinary cosmetics. They are lightweight but have a far greater covering quality and stay in place for much longer. On the body creams can be safely left in place for 2-3 days. The cream is fully waterproof, so you can swim with it in place.
The cover creams are tested directly on your skin to help you choose a suitable skin colour match. More than one colour is sometimes needed. A special powder is applied over the creams to make them waterproof. You will be shown step by step how to prepare and apply the products. The aim is to give you the skills and confidence to apply the creams yourself. Your first appointment will take 45-60 minutes. At the end of the consultation you will be given a letter to take to your GP who can then proscribe the creams on an NHS prescription. You will also be given an advice leaflet explaining how to apply the creams at home for yourself. A follow up appoint can be arranged you need further advice.
For an NHS appointment (for example for scarring) you will need to be referred to the camouflage clinic by your GP.
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There for you
One of our great achievements was to fund a clinical psychologist at the Norfolk & Norwich University Hospital who specialised in supporting breast cancer patients.
This service was not initially going to supported by the NHS, but after Keeping Abreast funded it for 18 months the Trust saw the value of it and decided to take on the funding.