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Invisible scars

Invisible scars unfortunately do not exist. Any break in the skin, whether from a fall against the pavement or from the surgeon’s scalpel will result in a permanent scar. The goal of plastic surgery is to make the scar as inconspicuous as possible. This is accomplished in two ways: (1) By making the scar as fine as possible and (2) by hiding the scar. Making the scar as fine as possible is accomplished by using meticulous technique, employing tension free closures, and using very fine suture. Yet, even a beautiful scar will always be visible to some extent. By hiding scars, we make them less visible.

The incisions we use in breast surgery illustrate the ways in which we can hide scars. By placing an incision in the axilla (armpit), the scar is hidden by virtue of the fact it is not on the breast. The down side, of course, is that the scar is readily visible when wearing something sleeveless. When the incision is placed in the breast crease, the scar is hidden by the natural ptosis (droopiness) of the breast. And when the incision is placed around the areola, it is placed at exactly the juncture of the areola skin and the breast skin. By placing the incision at the juncture of two different tissue textures, an optical illusion is created, making the scar less visible.

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