What are fibroses?

Fibrosis? word feared by those who do plastic surgery, especially liposuction. Remembered and associated with unsatisfactory results, complications or sequelae, after all what is unwanted fibrosis?

In the evolutionary chain, the human being lost the ability to regenerate tissues, starting to heal them. After trauma or damage to any tissue (skin, muscle, bone, etc.), the human body does not regenerate, ie does not produce a tissue like the one that was injured. Does it heal? produces a different fabric to the original to restore the damage suffered. It is as if after a hole in the street was laid tar and not asphalt, leaving a scar on the site.


Since the scar is a different tissue from the original, it does not have the same elasticity, softness and texture, behaving differently when pulled, subjected to tension, etc. As a result, scars can hurt in time changes or when stretched, as they do not adapt equally to healthy tissue and have different innervation and circulation.

And what is fibrosis related to all this?

Fibrosis is nothing more than the inner scar. It is a tissue predominantly made of collagen, used by the body to heal lesions. It is present in all the small holes that liposuction makes in fat, between loose skin and the muscle of any surgery, etc. If small, it causes no problems, and it is common to feel a slight tightening and tightening of the spot, especially in the first three months after surgery. Over time, fibrosis gets thinner and more malleable and less and less felt.


On the other hand, if very prominent, fibrosis can cause irregularities, significant hardening, nodulation, skin retractions and even pain. Not seen in the first two weeks, but usually seen and felt after 14 days and may get worse in the first three months. Between 6 months and a year of surgery tends to soften, but can leave sequelae.

The most important part of minimizing fibrosis, as it is inevitable, is a non-traumatic surgical technique. The less damage, the smaller the scar. For this reason, he usually uses only thin cannulae on his lipos and makes vibroliposuction.

Lymphatic drainage is also essential in surgeries with large skin detachments to minimize fluid accumulation in the tissues and spaces between the skin and muscle. The more fluid retained, the greater the scar to cover the space between the tissues, ie the greater the fibrosis. Ultrasound associated with lymphatic drainage is also critical in reducing fibrosis by modulating it and making it thinner. Of course we cannot forget the patient part, genetics. There are patients who are more prone to fibrosis than others.

Even if present, fibrosis in the early stages (14 to 21 days after surgery) is much more easily treated and resolved than old, already hardened and thickened fibrosis. The earlier treated, the greater the chance of success. Infusion of carbon dioxide (CO2 therapy or carboxitherapy) in fibroses under the skin also helps in recovery. By improving circulation and stretching fibrosis, carbon dioxide provides resorption and lacquering of the scar.

Given all this, it can be concluded that, although it is inevitable, fibrosis can often be modulated and, therefore, the diagnosis must be early, which makes follow-up postoperative fundamental.

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