FAQ Wound Healing & Scar Formation:

Here you’ll find answers

to the most frequently asked questions

After a plastic-aesthetic procedure, wound healing progresses through several phases. These phases vary in intensity depending on individual factors such as age and skin condition. In addition to precise surgical technique, regular monitoring and support of the healing process—both through clinical check-ups and appropriate patient behavior—are crucial for achieving the best possible individual result.
The wounds resulting from surgical procedures are so-called mechanical wounds (incision wounds).
The healing process can be divided into three main phases:
1. Cleansing Phase:
At the beginning of wound healing, the wound is cleansed through the discharge of wound fluid. A preliminary closure is formed by a so-called fibrin network, which protects the wound from external influences.
2. Granulation Phase:
During the granulation phase, new tissue begins to form, gradually filling the wound bed. This granulation tissue (commonly known as “proud flesh”) is essential for the further healing process, as it provides the foundation for the final closure of the wound.
3. Epithelialization Phase:
After about two weeks, the epithelialization of the wound begins. In this phase, skin cells (keratinocytes) close over the granulation tissue. The wound gradually contracts, and in the deeper skin layers, collagen fibers form cross-links. These collagen connections give the developing scar stability and help prevent the skin from tearing again.

The complete maturation of a scar after a plastic-aesthetic procedure takes about 1 to 2 years. After this period, the scar no longer changes significantly. It is advisable to begin intensive scar treatment during the first few months after wound closure—when cellular activity is at its peak—in order to support the healing process and achieve a smooth and inconspicuous scar. A key factor for optimal healing is an infection-free wound. Mechanical strain should also be avoided to prevent the wound from reopening or the scar from widening later on (so-called scar dehiscence). Therefore, it is important to minimize tension on the wound and avoid friction from clothing.
Nicotine negatively affects wound healing. Statistically, infections and healing complications occur much more frequently due to reduced oxygen supply to the wound. For this reason, it is strongly recommended to refrain from nicotine consumption for at least 4 weeks before and 4 weeks after surgery.
At the Wolff & Edusei Clinic, you will receive regular follow-up appointments for dressing changes, wound care, and clinical check-ups. It is very important that you attend these appointments to ensure optimal wound healing and scar maturation. Our specialists, Dr. Andrea Wolff and Dr. Isabel Edusei, together with our practice team, will be happy to advise you on all aspects of wound healing and scar care after your plastic-aesthetic surgery or beauty treatment.

Nicotine has a negative impact on wound healing. Statistically, infections and healing complications occur much more frequently due to the reduced oxygen supply to the wound. Therefore, the clear recommendation is to refrain from nicotine use for at least 4 weeks before and 4 weeks after surgery.
At the Wolff & Edusei Clinic, we address this topic with you early on and help you find ways to avoid putting your surgical outcome at unnecessary risk.

Immediately after surgery, the dressing protects the wound from the entry of germs and impurities and absorbs blood and wound fluid. As a rule, the first dressing change takes place on the first or second day after your plastic-aesthetic procedure at our clinic in Berlin. If there is bleeding into the dressing, an earlier change may be necessary. If an additional dressing or sterile plaster is required, it should generally be renewed every 1 to 2 days until the stitches are removed. We assist you with dressing changes and guide you on how to perform them at home, if needed. In most cases, you will not have to handle the dressing yourself during the acute healing phase.
In general, most wounds can continue to heal without a protective dressing after the first change. Scientific studies show no increased risk of infection if the wound remains uncovered after the initial dressing change. In fact, prolonged use of plasters and frequent changes may lead to additional discomfort, such as pain, skin irritation, or allergic reactions. We treat surgical wounds with specially designed, skin-friendly wound strips that lie directly and gently on the wound and can remain in place for several days.

The stitches are usually removed 7 to 14 days after a plastic-aesthetic procedure, depending on the location and the type of suture material used. We use both surgical sutures that dissolve spontaneously and non-absorbable stitches—sometimes in combination. There are no inherently better or worse types of sutures. The decision regarding which material is most suitable is made by the surgeon. However, it is helpful if patients share any previous issues with suture materials or problematic scar formation during the preoperative consultation so that the choice of material and technique can be individually tailored if necessary.
The exact timing of stitch removal is determined individually by the Wolff & Edusei Clinic team, which supports you during your aftercare, in consultation with our specialists, Dr. Andrea Wolff and Dr. Isabel Edusei.

In healthy individuals, a protective barrier of new tissue (granulation tissue) usually forms at the wound base within 24 to 72 hours after surgery, helping to shield the wound from infection. Contact with clean water and mild soap is generally possible at that point, provided no dressing remains on the wound after your plastic-aesthetic procedure. However, for surgeries on areas such as the chest wall or abdomen, we recommend allowing the wound to come into contact with water only after about five days, in coordination with the planned dressing changes.
In some cases—such as with open or delayed wound healing—gentle rinsing of the wound may be a useful part of wound care. However, it is important to consult your treating physician beforehand to avoid any risk. Hair washing is usually possible with care from the third day after surgery.

In general, the wound should not be subjected to stress too early. This is important to avoid pulling or tension on the wound and to ensure a consistent supply of nutrients through blood circulation. Too much strain too soon can, in the worst case, cause the wound edges to tear open or lead to a visually unappealing widening of the scar later on. Tension on the wound can also trigger excessive scar formation, as the body attempts to stabilize the scar through increased tissue activity. Even if the wound appears healed externally, full scar maturation can take one to two years.
As a general guideline, partial physical activity is advisable after about 6 weeks, while full activity should be resumed only after approximately 12 weeks.
Our specialists, Dr. Andrea Wolff and Dr. Isabel Edusei, will provide individual advice after your procedure regarding when strenuous activity and sports can be safely resumed to achieve the best possible scar result. The optimal timing also depends on the specific procedure performed—for example, a breast surgery or liposuction.

The most common wound-related complications are infections and postoperative bleeding.
For larger surgical procedures involving extensive wound areas, we administer antibiotics during surgery in accordance with medical guidelines, minimizing the risk of a systemic infection.
Infections usually occur when bacteria enter the wound. Symptoms of a wound infection may include pain, redness, warmth, and swelling, possibly accompanied by wound discharge and an unpleasant odor.
Localized infections can delay the healing process and lead to more visible scarring, so they should be treated promptly and appropriately.
If you notice signs of infection, you should consult your doctor.
In severe cases, bacteria may enter the bloodstream, leading to fever and chills. In such situations, you should immediately seek emergency medical care nearby.
During your medical consultation, it will be determined whether, for example, wound cleaning is necessary or antibiotics should be prescribed.
In the case of postoperative bleeding, further steps depend on the severity of the bleeding. If the dressing is soaked through, it should first be changed. A pressure dressing can help stop the bleeding. If this is not sufficient, your plastic and aesthetic surgeon should be consulted to discuss additional measures, such as surgical hemostasis.
The likelihood of postoperative bleeding depends on the type of surgery; in rare cases, coagulation disorders in the patient may also be a factor. The risk of bleeding decreases significantly after the first 24 hours following surgery.
If any issues arise, you should contact your plastic and aesthetic surgeon to discuss further treatment options.

Scar care can have a positive effect on the maturation of the scar, particularly through regular scar massage using suitable active ingredients. Our specialists, Dr. Andrea Wolff and Dr. Isabel Edusei, will be happy to advise you on this. With optimal wound healing and good individual predisposition, wounds usually heal well without additional measures. The right time to begin targeted scar care varies depending on the type of plastic-aesthetic surgery. Be sure to confirm the exact timing with your specialist, Dr. Wolff or Dr. Edusei.
Regular massage (twice daily for about 10 minutes or twice weekly for 30 minutes) can positively influence scar formation. However, not every scar is suitable for massage, and it should only begin after the stitches have been removed—typically around 3 weeks after surgery.
To support scar care and prevent excessive scar formation, silicone-based products (such as silicone scar creams or silicone scar sheets) can be used. However, these should only be applied once the skin—stressed by repeated use of dressings and disinfectants—has recovered with the help of moisturizing skin care and any remaining crusts have detached from the wound.
Our specialists and the Wolff & Edusei Clinic team are always available to answer your questions about wound healing and aftercare and to provide comprehensive guidance.

A wound fluid cavity, also known as a **seroma**, develops when the inner wound cavity—which is often much larger than the externally visible scar—fails to properly adhere and close.
This can occur, for example, due to excessive mechanical strain. Patients may notice it as a fluid movement (wound fluid) beneath the skin.
Surgeries that involve large internal wound areas, such as **mastectomies** (breast removal) or **abdominoplasties** (tummy tucks), are more prone to this.
If a seroma develops during the healing process, it can usually be drained easily from the outside, sometimes requiring multiple punctures. In some cases, the wound cavity may also need to be treated with medication.
It is important to maintain physical rest and consistent pressure on the wound—using, for example, a compression bandage or compression garment—so that the wound surfaces can reattach and heal properly.
In rare cases, a seroma may become infected or persist to the point that it requires surgical reopening.
Although this is usually not an emergency, it is important that patients report any suspected seroma to the **Wolff & Edusei Clinic** promptly so that early measures can be taken.

The final appearance of a scar depends on many factors, such as the location of the scar on the body, its position in relation to the skin’s natural tension lines, the patient’s age and sex, as well as ethnic and individual characteristics. Of course, careful surgical technique and comprehensive aftercare are also essential foundations for achieving an aesthetically pleasing scar.

In most cases, the development of bothersome scars can be prevented through proper aftercare. However, scars are also a natural result of any surgical procedure and should be accepted as part of the healing process. Most patients develop a very positive attitude toward their new body image and are not bothered by their scars.
Excision and re-suturing of scars are not advisable if doing so would increase tension on the scar area. When we encourage you to give your body time for the scar to mature, it is not to delay treatment, but to create a proper foundation for any potential surgical revision. This stage is usually reached after about 6 to 9 months. Often, time alone helps—allowing the body, with a little support, to resolve the issue naturally.
To keep scars as short and subtle as possible, we make use of the skin’s natural ability to contract during healing. This so-called retraction potential is significantly reduced in patients with poor skin quality, for example when stretch marks are present, and perfect results are not always achievable. Remaining tissue excess can almost always be easily corrected later—usually under local anesthesia and without the limitations associated with the initial surgery.
In some patients, due to individual factors, even a surgical revision may not lead to a better outcome and could, in the worst case, worsen the result.
At the Wolff & Edusei Clinic, we always assess and discuss your specific scar situation individually.