How Do Plastic Surgeons Avoid Leaving Scars?

How do plastic surgeons make incisions into people’s faces (like for a face lift, for example) without leaving a single scar? And if there apparently is a way to do it, why don’t other surgeons do it (like for heart surgery, for example)?


Apparently the skin has something of a “grain” to it like wood that they can cut with rather than against and thus avoid much scarring. How to recognize it, I don’t know. Look up “the pimple thread” and “Broomstick” and you’ll see how they did that in draining an infection in her cheek.

Why don’t other doctors do it? I couldn’t tell you with any certainty, but I speculate maybe that it’s something that takes a lot of extra training. That is to say, it’s the job of a plastic surgeon in part to make things look better than they did before, and scarring would be counterproductive. It’s the job of, say, a heart surgeon to make the heart work nice and not worry so much if there’s a zipper left behind.

When performing a facelift, many surgeons make their incisions along the hairline, where you’re unlikely to notice it after it fully heals. So there is indeed a scar left behind-- you just don’t notice it. 'Twould be rather pointless to have the surgery if you did, ne?

Actually they do leave scars.

You just don’t see 'em.

Plastic surgeons spend much time and effort learning to minimize and/or hide scars. As mentioned in a prior post, I have a small bit of experience with this sort of thing.

Yes, skin does have a “grain” to it. Wrinkles tend to run parrallel to it. Part of studying to be a plastic surgeon is learning how the grain runs on different parts of the body. If you cut along the grain the resulting scar is much thinner and less noticable than if you cut across the grain.

Plastic surgeons also use very tiny stitches when they must sew something up, or use other means to close wounds that leave minimal scars. There are types of bandages that also help scars heal in such a way as to minimize their appearance. After care can also play a role in how an incision heals.

On the face, in particular, scars can be hidden in the folds of the nose, behind the ears, in the eyebrow, the folds of the eyelids, and other places where the skin naturally creases up.

Why don’t other surgeons use these techniques? Well, many do make an effort to place incisions where there will be minimal scarring - it not only looks better, they usually heal better, too. But a plastic surgeon’s skill take years to master, just like a heart surgeon’s. How many specialties do you want the doc to acquire?

Away from the face, particularly in areas normaly covered by clothing, scarring is usually much less of an issue. In some cases where surgery is extensive or the person is prone to developing nasty, keloid scars a plastic surgeon might be called in to consult on ways to minimize the scarring, particularly in cases where heavy scarring might impair function. In other cases - like emergency surgery - the emphasis is on saving a life, not making the cuts look pretty. And some incisions are going to leave visible scars, like the infamous “zipper” from heart surgery. Certain lung surgeries also leave distinctive and very visible scars.

The point is, any incision leaves a scar. The real issue is how to do it so the healed result is almost unnoticable.

I had plastic surgery on my face after I had an accident (ran into a telephone face-first whilr bike riding), and had incisions on my face, where they’d be very visible. In fact, for a few weeks afterwards I looked like Frankenstein’s monster – skin all yellow and green, and horribly visible stitches like on a baseball. But the doc had apparently done a very good job of making the scars blend in, plus he put me on a daily regimen of massaging the area with cocoa butter. In a few weeks it had healed so well that even he had trouble telling which side the operation was on. To this day, it doesn’t show at all. Damned good work. (My only problem is that I went through plastic surgery on my face and I still look like me! Couldn’t they have made me devastatingly handsome while they were at it? On the other hand, I could’ve ended up looking like Michael Jackson, so maybe it’s just as well they didn’t.

I dated a paraplegic once, who’d had quite a bit ogf work done by an orthopedic surgeon, and her scars showed blatantly. She said that a lot of people in the hospital had a saying for sugeons who left such obvious scars – that they worked “like an orthopod.”

Really? I had neck surgery about 6 months ago to remove ruptured discs in my neck. The surgery was done by an orthopedic surgeon and he went in through the FRONT of my neck and you can’t even see the scar! He did a beautiful job! Maybe he just had excellent material to wok with! :smiley:


I have a friend who went through the windshield of a car and her face was horribly scarred. She had a lot of operations that lessened the scars, but they are still very much visible. Very sad.


Note to self: perform searches with “-pimple -Broomstick”.

My SO had rhinoplasty (nose job) and the surgeon did all of the work from the inside of her nose.

The face life that most people are familiar with is accomplished by making incisions in the hair line and behind the ears and literally peeling the skin away from the underlying musculature. The skin is pulled up tighter, the excess removed, and the skin reattached.

Just to make explicit something alluded to above, many operations require a certain type and location of incision to allow proper “exposure” and access. So, even if the surgeon did have extra skill/training in plastic surgery, there would be no way he/she could use it in such cases. Simply put, if the surgeon needs to be able to access an area of interest, and work therein, they’ll likely need to forego “cutting with the grain”.

I understand that for breast augmentation, they now can go through the naval.

The one on my leg, done by an “orthopod,” is barely noticeable (at least at the skin level). Due to the nature of the injury he was fixing up, however, I have some muscle atrophy there, which much therapy has been unable to remedy fully. So you can see clearly where I had the surgery (at least, if you’re looking), but it’s not because of the crappy stictching job for the most part.

What do they do with people who coud get keloid scars?

Discourage them from having unnecessary surgery, for starters.

Keloid scars are a real problem because surgical removal, dermabrasion, and so forth that are done to minimize other types of scars will only make them worse.

There are some new techniques, including new bandages, that can help if used during the initial healing process.

Years ago, they used to use radition to treat these. I suspect this isn’t done anymore.

How do plastic surgeons avoid leaving scars?

Well, after they finish operating on the plastic, they use a hair dryer set at the correct temperature to heat the surface of the plastic. Then they use a device similar to a miniture steam roller and smooth over the incision.

But that’s just the initial smoothing.

After the initial smoothing a liquid resin is sprayed on and after it hardens, or “cures,” it is followed by a light wet sanding of 600 grit sand paper. The process is repeated, spray, cure, sand with increasingly hight “grits” of sand paper, 800, 1000, 1500, until the desired sheen is achieved.

After that, common turtle wax can be used to give that ‘like new’ shine!

Hope that answers your question.

p.s. Don’t just use any old hair dryer as too much heat can cause shrinkage, vis-a-vie shrinky dinks.

What do you mean by that?

I had two moles on my face removed by a plastic surgeon. She had me grimace, and drew a line showing the direction of resulting wrinkles with a marking pen – she determined the "grain’ of the skin, as mentioned above. The incisions to remove the moles followed the direction of the marker lines. Further, the incisions were sutured in two layers with very fine suture material. The scars are visible, but look more like frown lines than normal scars.

Ah. Thanks.

What, “ne?”

It’s a variation of “no?” As in, “It’s been awhile since the Cubs had a winning season, no?” I don’t think it’s an expression I alone use, though it’d be difficult to search for another poster’s use of it.