The Importance of Scar Cosmesis across the Surgical Specialties: Factors, Perceptions, and Predispositions

Abstract

Background: Existing disparities in the perception of scars between patients and practitioners can translate into undesirable physical and psychological outcomes. An understanding of the determinants of surgeons' perceptions on the importance of scar cosmesis is a first step toward bridging this gap. Methods: In an online survey, surgeons were asked about the extent to which various patient and technical factors affect the importance of scar cosmesis. Additional data were obtained on surgeon characteristics, including their specialty, gender, years of experience, and work sector to investigate potential relationships. Results: A total of 303 responses were obtained from surgeons across six specialties. Based on the survey, the importance of scar cosmesis was rated highest among plastic surgeons and obstetricians and gynecologists, and lowest among orthopedic and vascular surgeons. Compared with surgeons in private practice, publicly employed surgeons' rating of the importance of cosmesis was lower. The patient's request for a cosmetic outcome was the most highly rated factor. Regarding the influence of patient demographics on surgeons' attitudes, scar cosmesis in young and female patients was favored in comparison with older and male patients. Factors that reduced the importance of cosmesis were emergency and late-night surgeries followed by lengthy procedures, large incisions, and busy operative lists. Conclusions: These initial findings highlight a need to investigate means of fostering a more holistic, impartial approach toward scar cosmesis, as well as addressing potential workplace barriers that may prevent surgeons from seeking a more cosmetic result. Greater alignment between the priorities of surgeons and patients may manifest in objective and subjective improvements in patient's scars and well-being.

Double knots versus triple knots facia closure method during cesarean section; is there a difference in pain sensation or cosmetic satisfaction? A randomized controlled trial comparing two different surgical methods in terms of pain and cosmetic satisfaction

“…Although this type of incision remains below the bikini line, it can cause itching, pain, tenderness, and signi cant psycho-social distress in addition to cosmetically disturbing symptoms and loss of function for many patients, especially when scar healing is not satisfactory (8). Nevertheless, there is a tendency among practitioners to underestimate the impact of scarring and the higher levels of concern among patients regarding postsurgical scarring than their surgeons (9) . Emergency, along with late-night on-call surgeries and lengthy procedures reduced the importance of cosmesis, which can be ordinary for C-section (9).…”

Interlocking intramedullary nail for forearm diaphyseal fractures in adults—A systematic review and meta-analysis of outcomes and complications

“…Removal of a nail does not necessitate repeat surgical dissection and does not leave as many areas of bone voids after screw removal. In addition, although scar cosmesis may be less of a concern to the orthopedic surgeon [ 23 ], Lee et al. reported lower satisfaction scores attributed to large scars in female patients receiving ORIF compared with IMN [ 15 ].…”