In physical therapy, you'll likely receive some scar massage - and technique instruction. It's not exactly a feel-good massage, to say the least. My therapist also does some "scraping" of the scar with a blunt metal object (like the handle of a butter knife). I've heard varying opinions on how often to administer scar massage, from 5 to 30 minutes, 2 or even 3x daily.
The appearance and texture of surgery scars seems to be dependent on each individual's genetics, and the location of your incision(s).
Almost IMMEDIATELY after my bandages were removed (day 11), my doctor instituted the use of this Silipos gel sleeve thing that covered, padded, and moisturized the scars. I wore it right over the steri-strips, and still continue to wear it now, 2 months post-op.
The gel pad has the added benefit of padding and protecting the sensitive surgical area. It also provides some compression. I couldn't have put my feet IN my shoes the first few weeks, without it. I'm convinced this little gadget has made all the difference in helping me form flat smooth scars. Only the top end of my scars (the 1/2" not covered by the gel pad) have begun to keloid.
In about weeks 8 & 9, I started to feel spots of thickening under the skin near the scar. In other words, even though it may look pretty on the outside, it's going to need constant attention to keep it from forming adhesions on the inside. Adhesions + stiffness = reduced joint mobility. Scar tissue can also cause pain.
Do creams and oils make a difference? I've read conflicting reports. Mederma, Vitamin E Oil, Cocoa Butter; does any of it make a difference? After reading product reviews on Skinstore.com, I wasn't convinced to buy anything. I've stuck with E Oil from the health food store.
Anyone with unique stories or techniques to share about success with scar massage or general scar care; please enter comments!
Another question, Lynn... Did you have your surgery done by an orthopaedic surgeon or by a podiatric surgeon and what do you think is the difference between each type? I know it is important to choose a board certified surgeon, however I have had patients tell me I should have the surgery done by a foot doctor and others are saying it's better to have it done by a bone doctor... What are your thoughts on this topic?
Posted by: Andrea Packard | March 12, 2009 at 06:42 AM
Well, I visited the doctor again and discussed with him the procedure in question and he said that with my severe IM angle (18 degrees) he believes any other procedure than the lapidus would fail. The main reason being that my feet are very hypermobile. I do not have structured flat feet but rather my arches are fairly high when I sit but when I stand they flatten out. This is referred to as excessive pronation. I have read a lot of articles online that support the idea that a high IM angle with hypermobility needs to be corrected with a lapidus procedure. Did you face the same issue, Lynn, and do you think that the Scarf-Akin procedure will hold up long-term? By the way, he did offer to give me Mederma for the scars. Oh and another thing--he stated that he doesn't advise having surgery done bilaterally because from his experience one foot always seems to heal better than the other. What were you told about this?
Posted by: Andrea Packard | March 19, 2009 at 07:00 PM