Scaring

[onset]

I am having my second OHS June 5th. Since my first surgery was done via right thoracotomy, this time they have to do a sternotomy. Is there any gain in having a plastic surgeon instead of heart surgeon close the incision to minimize the scaring?

 

[Allisoninoz]

Hi, I don't even know if that is an option. I had two right thoracotomies as a child (1972 and 1979) and those scars are still ridgy and uncomfortable and I don't like them being touched. I am surprised at how much better my new sternotomy scar is in comparison. I had my sternotomy for my BAV 15 months ago and it is nowhere near as sensitive as my side scars. There are far fewer nerve endings in the middle of your chest and that area doesn't move like your side needs to move. Most cardiac surgeons are very skilled at making the sternotomy scars as neat as possible. Good luck with your surgery.

 

[Jkm7]

I have had two sternotomy openings with the most recent being four years ago. I am feeling a little sad that I can hardly find the scar except in a few spots along the length. It has just about faded to invisible. The irony is I am a woman who really wasn't all that bothered when I wore v-necks or low cut tops and my scar was visible when it was new. If your scar doesn't heal smoothly and it bothers you, we've had members here who have sought help from dermatologist and maybe plastic surgeons.

I doubt most heart surgeons will agree to a plastic surgeon closing and it probably would make little difference.
Just make sure your surgeon does not intend to use staples. They leave the most obvious scar.
I had glue and steri-strips each time.

 

[Lynlw]

I have had two sternotomy openings with the most recent being four years ago. I am feeling a little sad that I can hardly find the scar except in a few spots along the length. It has just about faded to invisible. The irony is I am a woman who really wasn't all that bothered when I wore v-necks or low cut tops and my scar was visible when it was new. If your scar doesn't heal smoothly and it bothers you, we've had members here who have sought help from dermatologist and maybe plastic surgeons.

I doubt most heart surgeons will agree to a plastic surgeon closing and it probably would make little difference.
Just make sure your surgeon does not intend to use staples. They leave the most obvious scar.
I had glue and steri-strips each time.

I agree with the others that heart surgeons are very good now at closing incisions that usually look great after you heal, Especially as JK mentions IF they use glue/steristrips type closing of the skin layer of the incision and not staples or stitches. (which do tend to leave a worse looking scar - that is where the "zipper" description came from, which is probably what I would ask about preop if you are worried about a scar. Also depends on what kind of scarring YOU usually have, but from our experience, IF you tend to build bigger or keloidy types scars, it doens matter what kind of surgeons close you.

Beside the fact heart surgeons routinely close their patients in the nicest way, my GUESSS would be, trying to have a plastic surgeon hanging around to close the upper layers, would probably be a pretty long, tough thing to try and arrange and would most likely cause you alot of extra work and aggrevation at a time you probably wouldnt want to add more stress to your life. I really doubt unless there is a very good reason, even IF the heart surgeon would agree to it, that insurance would approve paying a plastic surgeons to close a first time sternotomy without extenuating circumstanses, at least without several appeals that would most likely move your surgery date and youd most likely end up with the heart surgeon closing at the end of the day anyway.

ALSO from our personal experience, because Justin had to have both a heart surgeon and plastic surgeon work on him for his surgery for his sternal and below his sternum infection, when his sternum and around his heart needed cleaned up and a muscle moved ( Plasitic closed his incions because his part of the surgery was after the heart surgeon was done) and ALMOST had another surgery a year later needing both sugeons, unless it is an emergency case, that would bump "elective" heart and plastic surgery patients, it can be very hard to coordinate a time that both surgeons can fit you in their schedual, since both can be pretty booked up weeks/months ahead for elective surgeries. Since you might not have a preference which plastic surgeon you want, it probably wouldnt be as bad as when we wanted a specific heart and specific plastic surgeons (the one who did his previous surgery) so had to find a time they both were available, but still Im not sure if it would be possible to arrange to have a plastic surgeon this close to your surgery date, depending how many plastic surgeons are on staff there.
BTW Justin's scar pretty much looked the same (pretty good) when he had a couple dfferent heart surgeons or the plastic, altho ike JK he never had stitches or staples outside, even the surgeries over 20 years ago

 

[AgilityDog]

Surprisingly, my second scar (right over top the first one) has healed even nicer than the first. Ditto my second pacemaker scar.

I just wish the bumps from the sternal wires were not visible, but I'm fairly thin, so they do show. If not for those, my scar would be even less noticeable than it is.

 

[Gail in Ca]

I knew a gal who got the okay for a plastic surgeon to close her up after her 1st OHS. I had already had my surgery a few yrs before and my scar, done by my surgeon, looked great. Well, her scar ended up really wide and thick because her body just made alot of keloid tissue, poor thing. It was much shorter than mine, but it wasn't what I would've expected from a plastic surgeon. So, you never know. I have always expressed my concern for a good looking scar from each Chief surgical resident that talks to me before surgery, as they usually close, and I have never been disappointed with the results.

 

[Eva]

I agree with the others. At this time, just make sure who is going to close you. I was surprised when I read, in the surgery report, that it was the NP was who closed me up! She did a good job. A part of my scar keloided later. I blame this on not having worn a bra for almost 12 weeks and me sleeping on my side!

 

[carolinemc]

Even if you do not get the okay for plastice surgeon, the scar should be a proud reminder that you are a survivor. It is a badge of honor and courage. Nothing to be ashamed. Some people will see it and ask questions. I remember as a child, after returning to school, after surgery and after a teachers' strike back in the 1970's, the kids asked me all kinds of questions that is normal curisity. I took it in stride. The second surgery, the scar is hardly noticable. So it depends on the way the insicion will be and if it fesible for plastic surgery. Good luck either way. You are great for coming in here. We are all good friends. Hugs for today.

 

[Tina-marie]

Scars after open heart surgery

Scars after open heart surgery

I am having my second OHS June 5th. Since my first surgery was done via right thoracotomy, this time they have to do a sternotomy. Is there any gain in having a plastic surgeon instead of heart surgeon close the incision to minimize the scaring?

I had my surgery in October last year and have the most frightful scars anybody has ever seen .Even my nurse said she would not let them sew her trousers...Lol
My scar came apart in three places so had to heal by second intention then I got an infection which made my sternum unsound.
I would speak with your surgeon and tell him/her that the neatness of the scar is important to you and you should be okay. Unfortunately my surgeon did not sew mine up and her assistant did.
I found silicone sheets really good and now I have a dermaroller.
This is a link to my scars topic;
http://community.bhf.org.uk/group/discussion/scars-after-open-heart-surgery
Either way take care of yourself and don't worry you are more than a scar
Tina-marie