The fastest way to make plastic surgery scars disappear [Brannon Claytor, MD, Philadelphia]

Eva Sheie (00:04):
Welcome to the podcast Where Before Meets After. Submit your questions for our experts at wherebeforemeetsafter.com. I'm your host, Eva Sheie.

Dr. Claytor (00:16):
Dr. Brannon Claytor. My specialty is plastic surgery and I am in the suburbs of Philadelphia. If anybody knows Villanova basketball, it's right near Villanova.

Eva Sheie (00:28):
You're an expert in incisions and scars now. Is that true?

Dr. Claytor (00:31):
Oh, yes. Well, I think we're all experts at incisions and scars, but I recently just won an award, best paper and PRS for my postoperative microneedling treatment. Yes.

Eva Sheie (00:43):
So what do you know about scars and incisions that most others don't know or are learning from you now?

Dr. Claytor (00:49):
Well, the basic science is well worked out. I think that what we're looking at now are challenging the paradigms, which traditionally have been leave things alone and let things heal on their own and then sort of reassess them at a year. And what we looked at was intervening early, intervening at six weeks or even a little bit later upwards is four months after an incision, with a mechanical treatment, and that's the microneedling process. And that really helped and accelerate the overall recovery and brilliance of the scar.

Eva Sheie (01:26):
Can that be any microneedling device?

Dr. Claytor (01:29):
Well, that's another research project that I'm about to dive into looking at microneedling with radio frequency. But this was done, I started this about five or six years ago, and there really weren't a lot of RF devices and it wasn't as nearly worked out or thought out back then. And so I think it's just an evolution in the process to move to look at RF microneedling devices.

Eva Sheie (01:54):
And if you were to go get a treatment on an incision or a scar, is it provider dependent in that you have to find someone who knows what they're doing, or can you just go to the old med spa down the street and ask them?

Dr. Claytor (02:05):
I think there is a degree of that surgical eye and that understanding of what a scar is doing at any one particular time so that you can determine the optimal time and the optimal depth and the optimal duration of your treatment.

Eva Sheie (02:22):
So would you be better off seeing a plastic surgeon or someone in a plastic surgery office supervised by a plastic surgeon?

Dr. Claytor (02:30):
I think that you probably had a surgeon make the scar. So it is very helpful to stick and have continuity of care.

Eva Sheie (02:40):
Very good answer. Very reasonable.

Dr. Claytor (02:45):
And that surgeon is likely going to be invested in that excellent outcome.

Eva Sheie (02:50):
The crowd agrees.

Dr. Claytor (02:51):
The crowd agrees cheering.

Eva Sheie (02:54):
What kinds of things do you recommend to your patients immediately post-op to help their incisions heal well?

Dr. Claytor (03:01):
Well, there are really two sets of incisions. I do a lot of facelifts and I do a lot of abdominoplasties. And so my facelift incisions, those wounds are merely approximated and then dressed with a little bit of topical type of ointment to help provide moisture and a protected environment. But if I'm doing an abdominoplasty or a breast surgery, I close my incisions with absorbable sutures and then I put on some sort of glue, a derma bond glue. I used to use pieces of tape and I found that those were not nearly as occlusive and the wounds leaked and they created a lot of anxiety for the patients. And there was a small egress potential for infection to work its way back into the incision. So I really like sealing the incision and the patients love it because I asked them to wash the next day right after surgery.

Dr. Claytor (03:54):
I want them jumping in the shower and letting water run over. So if the wound's sealed, then it's not going to leak and it doesn't become problematic. Facelift patients are a little bit different because you may be around the eye and different things, and so I'm not sealing those incisions, but if you're talking about the facelift incisions, all sutures are generally out by one to two weeks, whereas in the abdomen or the breasts, you're probably waiting one to two weeks for that derma bond glue or whatever type glue to fall off. So at about the same time, and that might be two to three weeks when they're coming back to see me, now we're talking about, alright, what are you going to do for the scar? What are you going to do to maximize that wound healing? And there are basically three things you want to do. And the first is a little bit of gentle massage, and the second is applying a thin layer of some form of silicone. And then the last is making sure that you're very good with sun protection. And if you are able to utilize those three tenants, those three pillars, you're going to already be ahead of everybody else.

Eva Sheie (05:09):
What kinds of things can people do to help themselves heal better and faster?

Dr. Claytor (05:14):
Nutrition is a huge part of it. There are a lot of vitamins that are out there. There's some incredible new products coming online that are going to be able to deliver more and more wound healing potential to the incision. Obviously, avoiding sugars, avoiding smoking, minimizing excessive activity. Although I am very liberal with getting people back to their regular activity. But the basic tenets of that are the same thing that probably your grandmother would've taught you, eat well, and avoid things that are bad for you.

Eva Sheie (05:49):
Also don't overdo it, let yourself rest.

Dr. Claytor (05:52):
It's true, but I like to push or allow my patients to push themselves. I half in jest say that for pretty much every operation at one week, you should be at 25% and then you go up 25% every week so that by it a month, I jokingly say, you should be able to go skydiving.

Eva Sheie (06:12):
That sounds good, like good advice. What if they've never been skydiving before?

Dr. Claytor (06:14):
Well always comes up, but it lightens it and it makes it a more approachable topic for everybody when you make it about something that you know they're never going to do. But they clearly get, they're like, I could go skydiving. Right? You're like, okay, that's the level that I'm at.

Eva Sheie (06:33):
Give us your Instagram and your website.

Dr. Claytor (06:36):
So the Instagram is @ClaytorPlasticSurgery, and my website is ClaytorNoonePlasticSurgery and Noone is spelled N-O-O-N-E. And it's a legacy to my partner who's retired, but Barry Noone, who is a giant in the world of plastic surgery.

Eva Sheie (06:53):
Thank you, Dr. Claytor.

Dr. Claytor (06:54):
Thank you so much.

Eva Sheie (06:58):
On this podcast, we bring you directly to the doctors who are, where before meets after. Links to our guest's website and contact info are in your show notes. Follow us on Instagram @wherebeforemeetsafter. If you're a board certified plastic surgeon and would like to be a guest or a sponsor of the show, go to wherebeforemeetsafter.com for more information. Where Before Meets After is a production of The Axis, the podcast agency for aesthetics, theaxis.io.