Why do some surgical scars look wonky while others look wonderful? Well, a large number of factors are at work during and after skin surgery that influence the way a scar will ultimately appear. How large was the surgical defect? How well did the patient care for the wound? Did an infection develop? Was the surgery site located in a place that required significant tension across the wound? Did a flap or a graft need to be used? What suture technique did the surgeon employ? The answers to these questions will all contribute to the final appearance of a scar.
One of our patients recently allowed us to post these pictures of his back after we surgically removed a skin cancer. As you can see he has had multiple skin cancers excised (only one of which was performed at our office) and when it comes to his scars, one of these is not like the others. Several of the scars you see are a result of a suturing technique that allowed significant tension to be placed across the wound with very shallow sutures. One scar is a consequence of use of deep and dissolving sutures only. If you need help figuring out which is which, you can scroll to the bottom photo.
You might also notice that the scars are different color. The newest scar (surgery was performed about two weeks prior to the photo) is the darkest in color and the oldest scars are almost white in color. This is because wound healing is something of an inflammatory process and the younger the scar, the more pigment you typically will be able to see. As time passes, the pigment will fade and you will see a similar color to all sites.
We hope you learned something new from this post. Suturing technique may not be the most exciting of topics to discuss, but it really matters.