Post-Surgery Scars: Management and Expectations After Hemorrhoid Surgery

Postoperative scars

Hello, Doctor.
In June of this year, I underwent hemorrhoid surgery at National Taiwan University Hospital.
The doctor mentioned that I had three mixed hemorrhoids with mild symptoms, but due to concerns about appearance and itching, I decided to proceed with the surgery.
In July, I was going abroad and consulted the doctor again.
The doctor examined the wound and noted that there was scarring, but it would gradually diminish over approximately 3 to 6 months.
During this period, I was advised not to return for follow-up visits, and I was told it would be fine to travel.
However, upon returning from my trip, I began to notice some swelling around the wound (as I had been walking a lot while abroad).
I waited for the scar to shrink, but it remained swollen.
In September, I traveled again, this time to South Africa, where the sanitary conditions were poor.
I was unable to wash with water after using the restroom and had to rely on wet wipes.
Due to the scarring, it was difficult to clean properly, and I often had to wipe vigorously multiple times, sometimes causing bleeding.
After returning home, I discovered that the scar had increased from one (about the size of a half-finger) to three, forming a large mass at the anal area.
I immediately went back for a consultation, but the doctor shrugged it off, saying, "It doesn't affect your health; it's just an aesthetic issue.
You have to accept that this is lifelong; it's a matter of your personal constitution.
Continuous friction on the wound will lead to further proliferation.
Using steroids will only slightly reduce the size, but it will only grow larger throughout your life.
You need to coexist with it; there are no medical solutions.
You chose to have surgery for a minor issue, which has now become a major problem due to inadequate postoperative care.
I will give you steroids," and then she was unwilling to discuss further.
I initially opted for surgery for cosmetic reasons, and the doctor did not provide any guidance on wound care.
Hearing that this condition would accompany me for life and continue to grow is truly distressing.
I cried and asked the doctor what to do, but she seemed indifferent and even skeptical about my claim that the condition was causing itching and daily suffering.
She merely rolled her eyes and smiled, saying, "You won't feel anything; if you don't think about it, it won't itch," showing no regard for my discomfort or concerns.
Is there really no hope for this scar? Are there no methods available to help me? Thank you, Doctor.

Nìmíng zhuó, 30~39 year old female. Ask Date: 2016/10/19

Dr. Ke Fangxu reply Surgery

External hemorrhoids, in addition to causing swelling during bowel movements that affects quality of life, also have cosmetic improvement as one of the indications for surgery.
If the surgery is performed for cosmetic reasons, the meticulous adjustment of the surgical wound is crucial to prevent the recurrence of anal tags that can affect appearance.
Less experienced physicians often overlook this aspect, leading to patient distress.
Given your current condition, it seems that you can only undergo another excisional surgery to improve the appearance; otherwise, conservative treatment may not achieve the results you desire.

Reply Date: 2016/10/19

More Info

After undergoing hemorrhoid surgery, it is common for patients to experience concerns regarding scars and the healing process. Your situation, where you have developed multiple scars that are causing discomfort and concern about their appearance, is not unusual. Let's break down the key aspects of post-surgery scar management and what you can expect moving forward.

Understanding Scarring After Surgery
Scarring is a natural part of the healing process following any surgical procedure, including hemorrhoid surgery. The body responds to injury by forming scar tissue, which is made up of collagen fibers. Initially, scars may appear raised, red, or discolored, but over time, they typically flatten and fade. The timeline for this process can vary significantly from person to person, depending on factors such as skin type, genetics, and the extent of the surgery.

In your case, the surgeon indicated that the scars would gradually reduce in size over a period of 3 to 6 months. However, it seems that your experience has not aligned with this expectation, as you have noticed an increase in the number and size of the scars, particularly after your travels.

Factors Influencing Scar Formation
Several factors can influence the formation and appearance of scars post-surgery:
1. Mechanical Irritation: As you mentioned, the friction from wiping with wet wipes, especially in a less-than-ideal hygienic environment, can exacerbate irritation and lead to increased scar formation. It is crucial to minimize any mechanical irritation to the surgical site to allow for proper healing.

2. Hygiene Practices: Maintaining proper hygiene is essential, especially after bowel movements. If water is not available, using gentle, non-irritating wipes can help, but be cautious not to scrub too hard, as this can lead to further irritation and bleeding.

3. Individual Healing Response: Each person's body responds differently to surgery. Some individuals may be prone to hypertrophic scars or keloids, which are raised scars that can develop when the body produces too much collagen during the healing process.

Management Strategies
1. Consultation with a Specialist: If you feel that your concerns are not being adequately addressed by your current physician, consider seeking a second opinion from a dermatologist or a plastic surgeon specializing in scar management. They may offer additional insights or treatment options.

2. Topical Treatments: While your doctor prescribed a steroid cream, there are other topical treatments available, such as silicone gel sheets or creams, which can help flatten and soften scars. These treatments are often recommended for hypertrophic scars and can be effective if used consistently.

3. Avoiding Irritation: As you continue to heal, try to avoid any activities that may irritate the area, including excessive wiping or tight clothing. Allowing the area to breathe and heal naturally can help reduce scar formation.

4. Scar Revision Procedures: In some cases, if scars remain bothersome, surgical options such as scar revision or laser therapy may be considered. These procedures can help improve the appearance of scars but should be discussed thoroughly with a qualified specialist.

5. Emotional Support: It’s important to address the emotional impact that scarring can have. Consider speaking with a counselor or joining a support group for individuals who have undergone similar surgeries. Sharing your experiences can provide comfort and coping strategies.

Conclusion
While it may feel overwhelming to deal with the aftermath of your surgery and the resulting scars, it is essential to remember that there are options available for management and improvement. Scarring is a common issue, and with the right care and attention, you can work towards minimizing its appearance and discomfort. Be proactive in seeking the care you need, and do not hesitate to advocate for yourself in discussions with healthcare providers. Your comfort and well-being are paramount, and there are professionals who can help you navigate this journey.

Similar Q&A

Post-Surgery Scar Concerns: Achieving a Smooth Recovery After Hemorrhoid Surgery

Hello, Doctor :) I underwent surgery on March 5th of this year to remove a grade IV internal hemorrhoid and necrotic tissue around the anus. I had the procedure done at a cosmetic clinic that specializes in minimally invasive surgery, and I didn't need to be hospitalized. It...

Dr. Yu Mingchang reply Surgery
Hello: Please take a moment to check the colorectal department at Changhua Hospital, which cares about you.

Do Hemorrhoid Surgeries Leave Scars? Expert Insights and Tips

Hello, doctor. I would like to ask if hemorrhoidectomy will leave scars on the anus, as I found online that some people experienced discomfort due to hardened scars, and I also care about aesthetics. If scarring is likely, would applying scar gel on the wound after surgery be hel...

Dr. Zhang Shuhao reply Surgery
After hemorrhoidectomy, the healing site may slightly lose elasticity due to fibrosis, and like wounds in other parts of the body, there is a chance of scarring. The visibility of scars primarily depends on the individual's constitution and the size of the external hemorrhoi...

Post-Surgery Concerns: Managing Pain and Healing After Hemorrhoid Surgery

Hello, doctor. It has been two months since my surgery for internal and external hemorrhoids. Previously, I experienced pain when pressing on the skin on the right side of the anal area and while sitting, which was described as pain from the scar stretching during bowel movements...

Dr. Ke Fangxu reply Surgery
Online consultations cannot replace clinical diagnoses, and a patient's subjective description cannot substitute for a physician's observations and examinations. It is indeed concerning that you are experiencing multiple issues after your surgery; however, it is essenti...

Understanding Post-Surgery Scar Issues After PPH Procedure for Hemorrhoids

Hello Dr. Yu, I have a circumferential mixed hemorrhoid and underwent PPH (Procedure for Prolapse and Hemorrhoids) surgery at a reputable hospital over four months ago. Since then, I have been experiencing anal pain, swelling, and a sense of urgency, which has been particularly s...

Dr. Yu Mingchang reply Surgery
Hello: Scars after surgery may take up to 6 months to soften. Eating more fruits and vegetables is recommended. Changhua Hospital cares about you.