Most patients considering plastic surgery are concerned about the placement of incisions and scarring. For many patients, this is the most important concern. In most cases, plastic surgeons have been trained to conceal an incision in an area of the body that is not conspicuous. For example, a tummy-tuck incision is hidden in the bikini line, eyelid incisions are made in the folds of the eyelids, facelift incisions are behind the ear and in the hairline and breast augmentation incisions are concealed on the border of the darkened-nipple skin and the light-breast skin.

However, scarring is a separate matter. Each patient heals differently. A scar is the body's response as it attempts to heal from a surgical incision. Generally, scars look good the first week or two, but as the body begins to heal the scar takes on a different appearance. The scar may become red or pink in color and may become thickened. These are normal responses as the body increases blood flow to the incision in order to heal it and produces collagen to give the incision/scar strength. As time passes, the scar matures because the body reduces blood to the area, which makes the redness fade and the collagen is partially reabsorbed, improving thickness. This process may take 12 months or longer in some cases.

During scar maturation your surgeon may give you instructions to help improve the appearance of the scar. Typical measures used to improve the appearance of the scar include massage of the scar, limited sunlight, application of ointments, placement of silicone sheeting on the scar and injections of steroid solution into the scar. While these measures help improve scarring, it is more important to give the scar the appropriate amount of time to mature and improve its appearance on its own.

The majority of patients will have a very good to excellent cosmetic result. Unfortunately, a very small percentage of patients will not have a good result. If a scar is not satisfactory after 12 to 18 months, a surgeon can often intervene by excising the scar and starting over.

• Before and After Photo Gallery