Dr. Sam Lam - Plastic Surgery Forum

Hi Dr Lam. I finally took the time to register. I’m a huge fan of your work, thanks to you I found out about the geometric broken line scar revision, and even if most doctors say that a fat transfer in the face should last only a few months, the truth is that if done correctly, it can last for years and improve skin quality in the meantime.

In a couple of your video diaries (Postoperative Wound & Incision Care, How To Clean Your Facelift Incision), after keeping the wound dry for the first 24 hours, you emphazise the Q-tip/Peroxide/Bacitracim method for the next seven days. While checking your channel on youtube I saw a video of a forehead GBL scar revision (inverted V), in there you showed the post-op one day after the procedure with steri-strips covering the scar.

1) My first question is, how can someone apply peroxide/bacitracim if he/she has steri-strips on the scar?

2) If someone already knows that he/she is allergic to bacitracim, is it safe to use Vaseline the whole seven days after the surgery? Any risks with this product? (Of course, after waiting the first 24 hours)

3) Some people say that if you let an incision scab over, the skin will not grow at the same level of the surroundings, resulting in a slightly depressed scar. ¿What’s your opinion about this?

My apologies for such dumb questions, sounds logical to me the use of steri-strips to lessen tension over the wound, but at the same time I’ve read several articles about the benefits of a moist enviroment in order to speed up healing and improve scar quality.

Thanks in advance !

1) My first question is, how can someone apply peroxide/bacitracim if he/she has steri-strips on the scar?
great question. you can't. there is a trade off with steri-strips. i don't always use them. today i use them less and tend to create a 3 layer closure with the last layer really tenting the skin up like a ridge so that the skin will settle even flatter. by doing so, i leave the wound open to the air so that you can apply a moisture ointment.
2) If someone already knows that he/she is allergic to bacitracim, is it safe to use Vaseline the whole seven days after the surgery? Any risks with this product? (Of course, after waiting the first 24 hours)
yes, vaseline tends to be very safe. if there is any question, put a little vaseline on your left wrist and wait 72 hours. if you have no reaction, then you should be fine. for those very very very rare vaseline reactions, i use crisco which has almost no allergic risk. always use a new vial of vaseline not one where your dirty fingers and feet have been in.
3) Some people say that if you let an incision scab over, the skin will not grow at the same level of the surroundings, resulting in a slightly depressed scar. ¿What’s your opinion about this?
aha! read #1. the third layer has greatly facilitated a flatter result.
thanks for the questions.
best,
sml