Dr. Gorman responds to a common question that we hear at pre- op and post op.
A: Collagen is the most common protein in the body and is necessary for life. It is mostly found in the connective tissue in all parts of the body, and it is involved in healing. The question of too much collagen relates to the formation of thick scars which are higher than the skin surface; either hypertrophic scars or keloids. Hypertrophic scars usually form in areas of injury or wounds closed under excessive tension. Keloids can form in the same way but usually grow well beyond the area of injury and may persist much longer and be painful. Keloids may arise unexpectedly but there may also be a genetic component. Both lesions represent abnormal wound healing and inflammation. While there is over production of different types of collagen in both of these types of scar, the collagen is the result rather than the cause. There are many factors that must be considered by the surgeon in predicting the kind of scar that can result from surgery. There are places on the body which tend to scar better than others. Handling the wound edges gently, choosing the right type of closure and sutures, prophylactic and therapeutic strategies as well as continued research- all are necessary in preventing hypertrophic scars and keloids. - Dr. Gorman