When recovering from breast reconstruction surgery, the initial phases of the wound-healing process are expected to take around four to six weeks. Within 3 months, the wound repair is almost as strong as it was before surgery. The entire wound healing process might take a couple of years to complete and for scars to fully mature. This time can be split into four distinct stages that are used to categorize the complex bodily processes that automatically happen during this time.
Other medical issues that also contribute to slow wound healing are diabetes, high blood pressure, obesity, vascular disease, and long-term use of certain medications. Infection, edema, insufficient nutrition, and repetitive trauma to the wound can also inhibit wound healing.
Stage 4: Maturation Stage
The maturation phase of the wound-healing process normally begins about three weeks after the wound begins to heal. It’s the longest stage, lasting for up to a year or more depending on the severity of the wound.
The cells previously used to repair the wound area are removed through the process of apoptosis (programmed cell death). New tissue is also altered, reinforced, and fully closed.
Collagen, the main element that makes up scar tissue, is remodeled from “type III” to “type I”. Type III collagen is made of thinner, disorganized fibers that are formed during the proliferative stage (stage 3 of wound healing), while type I collagen fibers are stronger and more organized.
This transition occurs when collagen fibers align with skin tension lines. These collagen fibers arrange closely together and cross-link, reducing scar tissue thickness and making the wound area stronger.
The myofibroblasts produced during the proliferative stage continue to close the wound. This contraction peaks around three weeks after an injury during the maturation phase.
While this process does reinforce the wound, scar tissue will never be as strong as uninjured tissue. This area can only recover up to 80% of its previous strength, with around 50% being reestablished within six weeks.
At first, flat (cicatrix) scars are generally pink or reddish and slightly raised; often, this normal scarring is also itchy or painful. With proper care, these scars flatten and change color, becoming slightly paler or darker than surrounding skin.
It’s important to remember that wound care affects how skin heals. Taking proper care of this area throughout the wound-healing process can help minimize scarring. Stay tuned for our next blog series to learn more about scar types, risk factors, and treatments.