Scar quality after facial surgery is determined by two things: surgical technique and post-operative care. Dr. Truesdale’s incision placement and closure technique are designed to minimize visible scarring — but what happens in the months after surgery determines how completely those scars mature and fade.
How Scars Mature
All surgical scars follow a predictable maturation timeline. In the first six weeks, the scar is red, slightly raised, and firm — the wound is depositing collagen rapidly. Between 6 weeks and 6 months, the scar begins to flatten and lighten. Between 6 and 18 months, the scar continues to fade and may become nearly imperceptible, especially when hidden within the hairline or in the natural shadow of the ear’s contour. This is why final scar judgment should not be made before 12 months.
The Scar Care Protocol
Once incisions are fully closed and sutures removed, the following protocol is appropriate for most patients:
- Silicone gel or sheeting: The highest-evidence intervention for scar improvement. Apply silicone gel twice daily starting as soon as incisions are closed and dry. Silicone sheeting worn overnight is an alternative.
- Sun protection: New scars are highly susceptible to hyperpigmentation with UV exposure. Apply SPF 50+ (mineral-based) daily to any scar in a sun-exposed area for the full first year. This is non-negotiable.
- Massage: Gentle scar massage with a neutral oil or silicone gel beginning at 6 weeks helps break up adhesions and soften raised tissue.
Melanin-Rich Skin
Patients with darker skin tones are at higher risk for post-inflammatory hyperpigmentation (PIH) and keloid formation. Dr. Truesdale’s incision techniques specifically account for this. If you have a history of keloids or hypertrophic scars, disclose this at your consultation. A more aggressive preventive protocol — including early steroid injection or pulsed dye laser — can be planned in advance.
When to Be Concerned
Scars that widen, remain raised after 6 months, or develop a ropey texture may benefit from in-office treatments including pulsed dye laser, fractional laser resurfacing, or intralesional steroid injection. Early intervention produces the best outcomes. Contact the office at any point if your scar’s progression doesn’t match the expected timeline.