What are fibrosis?

Fibrosis – word feared by those who undergo plastic surgery, especially liposuction. Remembered and associated with unsatisfactory results, complications or sequelae, after all, what is the 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 organism does not regenerate, that is, it does not produce tissue equal to the one that was injured. It heals – produces tissue different from the original to restore the damage suffered. It is as if after a hole in the street, tar was placed and not asphalt, leaving a scar in the place.

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. Therefore, scars can hurt in weather changes or when stretched, as they do not adapt equally to healthy tissue and have different innervation and circulation.

And what does fibrosis have to do with all this?

Fibrosis is nothing more than the internal scar. It is a tissue predominantly made of collagen, used by the body to heal injuries. It is present in all the little holes that liposuction makes in the fat, between the loose skin and the muscle of any surgery, etc. If in small amount, it does not cause problems, being common a sensation of tightness and light hardening in the place, mainly in the first three months after the surgery. Over time, the fibrosis thins and becomes more malleable and is less and less felt.

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

The most important part of minimizing fibrosis, as it is unavoidable, is a minimally traumatic surgical technique. The smaller the damage, the smaller the scar. For this reason, he usually uses only thin cannulas for liposuction and vibroliposuction.

Lymphatic drainage is also essential in surgeries with large skin detachments, to minimize the accumulation of fluid in the tissues and in the spaces between the skin and the muscle. The more fluid retained, the greater the scar to cover the space between the tissues, that is, the greater the fibrosis. Ultrasound associated with lymphatic drainage is also essential to reduce fibrosis, modulating it and making it thinner. Of course, we cannot forget the part of the patient, genetics. Some patients 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, hardened and thickened fibrosis. The earlier it is treated, the greater the chance of success. The infusion of carbon dioxide (CO2 therapy or carboxytherapy) in fibrosis below the skin also helps in recovery. By improving circulation and stretching fibrosis, carbon dioxide provides resorption and tearing of the scar.

In view of all this, it is concluded that fibrosis, despite being inevitable, can often be modulated and, therefore, the diagnosis must be early, which makes the follow-up postoperative fundamental.