Facial Wound Care
Facial wounds can result from trauma, removal of moles or skin cancers, cosmetic facial surgery or after corrective jaw surgery. To achieve the best result and the least noticeable scar you must participate in the next phase of facial plastic surgery, the “healing” phase. Please ask me or my staff if you have any questions.
You may have some pain once the local anesthesia (numbing medicine) wears off. If I have given you pain medication, take it as directed. Always take pain medication with some food or liquid to decrease the chance of getting an upset stomach. If I have not given you anything for pain (and you are allergic) you may take: Tylenol (Acetaminophen) or Advil (Ibuprofen).
All wounds develop crust- this is simply dried blood. If your wound should open or if you have persistent bleeding, apply firm pressure on it for 15 minutes by the clock. Give me a call if this does not stop the bleeding or if you have any questions.
You will have stitches to keep the skin edges together as the wound heals. In some cases the stitches will melt away on their own. In most cases, they have to be removed. We will tell you which kind you have.
Cleaning your wound:
Peroxide: Gently use peroxide on a Q-tip and let the crusts bubble off. (Do this 3 times per day.) NOT PICK THEM OFF as this may delay healing and leave a deeper and more noticeable scar.
Soap and water: Gently wash the area and then pat dry. Use a mild, plain soap, like Purpose.
Ointment: Apply a thin film to the stitches each time after you wash them. Do this for the 1st week. You may then switch to a silicone gel (like Mederma) for another 8 weeks as directed.
Steri-strips: Depending on the type of wound you have, I may suggest using ster-strips. These paper tapes are to be applied across the wound to give it extra support as it heals.
OK after the 1st day. Avoid direct spray on the wound which may be painful for the first few days and which might cause the wound to open.
You may have some bruising in the area of the wound. This is expected and some patients are more prone to this than others. Typically, it will fade slowly over 14 days. Green-based cover makeup can very effectively help hide this. Avoid Aspirin and alcohol for 2 weeks after surgery to help minimize bruising.
Facial infection is rare. You may be given a prescription for antibiotics; if so take them as directed and take all of the pills. Keeping your wound clean will minimize the risk of infection.
A scar forms any time the skin is cut. This is how the body heals. You will notice that the edges of the wound may be higher than the surrounding skin. This is done on purpose. As the wound heals, it will flatten out naturally. The area will be itchy and red for several weeks to months after surgery. This again is part of the healing process.
It is ESSENTIAL that you use caution in the sun for 6 months after surgery. Your new wound is unable to resist the damaging effects of the sun and may develop a brown “tattoo”- the area of the scar will be darker in color than the surround skin- that will be present all year long. This is the body’s attempt to protect itself. If you must be outside wear BOTH a sunscreen (30 spf or better) and protective clothing (hat).
In some cases the scar will need to be “improved” or revised after the first surgery. It is always possible to predict who will or will not need this done. (Usually we know by 3-6 months after the 1st surgery.) There are three major ways this is carried out:
- Removing the scar: If the area has healed poorly for whatever reason and especially if it has widened, it must first be removed by cutting it out and then putting the skin back together to allow for a new healing process.
- Dermabrasion: This is a surgical “sanding” of the skin edges to make them even and flat. It is done for thin scars with uneven edges that cast shadows which make them more noticeable.
- Steroid injection: Some scars have a tendency to widen dramatically or develop thick, heaped-up edges (keloids). Often these can be improved by injecting a small amount of anti-swelling steroid into the scar itself. This may have to be repeated several times.