LAM FACIAL PLASTICS

Dr. Lam,

I understand that after a scar revision surgery, keeping compression on the wound and injecting 5-fu/steroids are two methods to help reduce scarring.

Now there are some claims on the Net that it is not good to apply compression on a wound that has already been injected with kenalog (no reason provided).

Is there any basis to such claims? And if so, what is the biological rationale behind it?

i have no idea, to be honest. the only time i consider compression is with keloids. however, i typically get keloids that have already failed a lot of treatments so i move toward radiation as an adjunct following excision so i typically do not need compression. for hypertrophic scars, i think that is excessive and does not work well. in short, i have no answer to your question.

A follow-up question is, even if a patient is not prone to keloids, does compression not help flatten the surgical scar and reduce scarring, ultimately resulting in a smoother and better scar? From what you said, it seems that compression actually does very little to help scarring at all?

my feeling is no, but i do not want to be dogmatic. if you can find studies that prove the contrary or a doctor that has significant experience to prove me wrong, then i am okay to be proven wrong. believe it or not, i don't know everything. but what i told you is what i tell my patients.
best,
sml