The Truth About Scars

Scars. They’re the holy grail of plastic surgery—the thing every patient fears, and every surgeon tries to downplay. We’ve all heard it: “I’d get a tummy tuck, breast lift, or arm lift… if only it weren’t for the scar.” In this no-nonsense episode, Dr. Rady Rahban exposes the truth about scars: why they form, what really determines how they heal, and the industry secrets most surgeons will never tell you. Here’s what you’ll discover:

• 🚨 The 3 key factors that decide how your scar will look: your genetics, what happens during surgery, and what (little) matters afterward.
• 🩺 Why the way your surgeon closes your incision is the single most important predictor of your scar’s outcome.
• ⚠️ The shocking reality that in many operating rooms, your surgeon isn’t even the one closing you up.
• ❌ Why expensive creams, lasers, and scar protocols are mostly hype — and what actually makes the difference.
• ✅ Dr. Rahban’s meticulous closure techniques that produce scars far better than industry “norms.”

If you’ve ever wondered why some scars are practically invisible while others look unsightly, this episode will change the way you view plastic surgery forever.

🎧 Tune in now for the uncensored truth about scars — and share this episode with anyone considering surgery. It could save them from a lifetime of regret. 

👉 Follow @DrRadyRahban on Instagram, TikTok, and YouTube for more unfiltered insights.
💬 Have questions about scars? Drop them in the comments — they may be featured in a future episode! 

Episode Transcript

Speaker 1 (00:06):
Welcome to another episode of Plastic Surgery on Censored. I'm
your host, doctor Roddy Raban, and today we're going to
tackle I think one of the probably the ultimate most
important single issue in plastic surgery, your scar. In other words,
the holy grail in plastic surgery is to do surgery

(00:28):
alter your nose, your face, your stomach, or whatever, and
have essentially zero sequali or any sign that anybody was there.
And ninety percent of the sign is really the scar
that is formed in order to do it. Now, there
are a handful of surgeries that have minimal scars rhinoplast
the liposuction, etc. That the scar isn't an issue, But

(00:50):
for the overwhelming majority of plastic surgery, the scar is
one of the major hurdles, hurdles or obstacles for people
in order to do it right. So take, for example,
tummy tuck. Oh I would do a tummy tuck and
a heartbeat if it weren't for the ugly scar. Oh
breastlift reduction, Oh, I do it in a heartbeat if
it weren't for the ugly scar, arm lift, thigh lift,

(01:10):
and so on and so forth. So I have spoken
about this subject one million times, and this will be
one million and one. Why do I keep talking about
it because it is the number one most important thing
and it is the most misunderstood, misled led about deceptive
aspect of plastic surgery. So I'm gonna break it down

(01:31):
for you today during this podcast. So if there was
ever any doubt, it would be clear today. So number
one thing you need to understand is your scar. The
ultimate scar let's just pick from a breast lift. Is
comes down to three key elements. Number One, who you

(01:52):
are aka your genetics, your predisposition. Number two, what is
done during surgery? Number three what is done after surgery?
Again one, who are you? Two? What is done during surgery?
Three what is done after surgery? So who you are

(02:13):
is who you are. Some people, they're lucky their bodies
are predisposed to making thin, flat white scars. By the way,
notice there is no such thing as scarless. Scarless meaning
I cut you and it doesn't leave a scar is
for the future. I mean that's like you know, placenta

(02:34):
da da dad. That doesn't accept happen unless you do
surgery in utero. Okay, but for humanity, regular mammals, when
I cut something, they'll be a scar. So what is
our goal for it to be a beautiful scar versus
an ugly scar, for it to be essentially invisible versus unsightly.
So who you are, your genetics, your predisposition has a

(03:00):
significant part to do with what you'll ultimately have. There
are individuals, they are very rare, who develop keloids. They
literally go and pierce their ear, single puncture and poof,
they make a cauliflower scar. They represent a tiny minority
that is not the common. Most people make a pretty
decent scar, and some people are very lucky and they

(03:22):
make a great scar. Genetically. An interesting issue that people
don't really understand that it's actually counterintuitive, is one would
think that a child heals better than an old man,
and the reality is that it's actually the opposite. Why
is that children make an immense amount of collagen. They
make a robust, phenomenally thick and raised scar. From a

(03:48):
biologic standpoint, that's a fantastic scar. Older patients don't generate
nearly as much collagen. They don't have as much wound
healing potential, so they make a thinner, flatter, shittier scar.
From a cosmetics point, that's amazing. So it's actually counterintuitive.
But generally and by and large, most people heal reasonably well,

(04:10):
and for the most part, there's nothing it can do
about it. In other words, it is whatever it is.
Oh God, I wish I healed more like my sister.
It doesn't matter, you're set. The most common thing I
hear for patients to come for revision is I had
surgery blah blah blah blah, and my doctor said, my
terrible scar is because I heal this way. And while

(04:31):
there might be some truth to that, overwhelming majority of
it is a lie. What do I mean? I mean that, Yes,
if I, doctor Rabond close you patient X shitty, I
do a terrible job. In other words, the part I'm
about to go into, which is what I do during surgery,

(04:51):
then you will make a shitty scar. I know that
because in those patients that I do revisions in come
in horrible scar. Surgeon before them told them, listen, there's
nothing I can do. You just make shitty scars. I
redo the scar, change the way I do the scar
that they had it done, and the heel beautifully. So
what does that tell you? It tells you that it

(05:12):
wasn't the patient. It was actually the closure. So then
we shift from who the patient is, that is what
is your predisposition, to the bulk of your scar, which
is what we do during surgery. So pay close attention
because this actually is the only or the biggest variable

(05:32):
in the outcome of your scar, and this is what
we can actually change based on who and how and
what we get done. Number one, how did they open?
In other words, when they made the initial cut? Was
it predominantly done with a blade which is sharp and
a traumatic or do they go right through the skin
and then use a cattery which is electric cattery and

(05:55):
charge the edges and get through the dermis. Why is
that relevant? It's relevant because when you burn your way
through the skin, you create a thousand degree heat inflammatory
issue that later goes on to making thick scar. What
do you think is going to happen when I burn
the edges of your skin in three months? In six months,

(06:17):
that tissue, that scar edge that comes together is now inflamed. Well,
how do you do it? I use a blade, I
only use a blade, and I go through the whole
thing with blade, and I get past the skin and
into the fat. And only when I'm in the fat
do I start using the cottery. Well, then why don't
other doctors do it? Because when you go through the
dermis with a blade, it bleeds like hell and it's annoying.

(06:41):
So what do doctors do. They go through the skin,
and then before they go through the dermis, which bleeds,
they cauterize the edges of it so it doesn't bleed
and annoy them. Well, then how do I deal with
the bleeding? I pre inject you with epinephrine. So when
I'm getting you ready for surgery, I put an epinephrin
in all your incisions. Wait fifteen minutes, and then I cut.

(07:04):
Then the bleeding is minimal and I don't have to
burn the edges of your skin. Next, when they're handling
your tissue, the tissue, the flap of your abdomen, your thigh, whatever,
how do they handle it? And often the edges of
tissue are crushed. They're grabbing it with clamps or four
steps and they're squeezing the shit out of your tissue.

(07:25):
What's inside that tissue is blood, vessels and collagen and cells.
And what do you think is gonna happen if I
sew together tissue that's a traumatized hasn't been traumatized, versus
if I sew together tissue that's been crushed or squeezed,
which do you think is gonna heal better? You don't
need to be a scientist to know that if you

(07:46):
treat the tissue roughly, it won't heal as well. This
is commonly seen with orthopedists. Orthopedists open up a wound,
do their surgery pull on the edges, crush it as
they're putting in hardware, and then they'll call the plot
surgeon to come and close, and the wound heals like shit, Well,
you crush the shit out of the tissue that you're
about to heal. So that second when they close it,

(08:10):
how much tension is there? How tight is the wound?
Remember much of plastic surgery is cutting out tissue and
sewing it back together. So if I make your ABDOMINOPLASTI
tummy tuck too tight, if I make your abdom your
facelift too tight, the edges of the wound are constantly

(08:30):
pulling apart. The human body is so brilliant it knows
that there's too much tension, and instead of unraveling and
widening and getting open, it tells itself on a cellular level,
Make more collagen, make more collagen, put more cement into
this so it doesn't fall apart, so you get a

(08:52):
thicker scar when there's too much tension, very commonly seen
in a tummy tuck. Next, how much blood set apply
is going to the edge. Remember, much of plastic surgery
is about cutting and lifting and pulling. When we lift,
we go underneath the skin or tissue, and we're cutting

(09:12):
blood supply. So if you were to examine the amount
of blood supply to the edge of a wound, it
will tell you how much nutrition is getting there. And
sometimes surgeons are very aggressive about undermining going underneath that
they get a schemic, which means they don't get enough
blood supply, and then the tissue starts getting dark and

(09:35):
necrotic and dies. And of course what's going to happen
to your scar. It's gonna heal like garbage, and it's
going to be thickened and raised. Those are very important. However,
the single most important aspect of your final scar is

(09:58):
how is the incision closed? Did you guys all hear me?
I'm gonna repeat it for you. The single most important
predictor of how your ultimate scar will look like in
two years from now is how was the incision closed
during surgery? So here we go. So the edges are

(10:21):
far apart and someone has to put it back together. Well,
what do you mean someone? I mean that ninety nine
percent of surgeons, yes, plastic surgeons who do body contouring, brass, tummy, arm, thighs, etc.
Not those jobs and eyelids have someone who helps them close.

(10:46):
All professionals who do a lot of major work have
people who help them. Busy lawyers have paralegals who help
them do research. Busy accountants have bookkeepers who do the number.
Busy architects have draftsmen draw up plans. Busy dentists have
hygienis do cleaning. Busy waiters have busboys who clean the tables.

(11:11):
You see the pattern. So busy surgeons have someone help
them close, guaranteed. Okay, Well who is that person? You
better ask your surgeon, not who's in the room, not
who's helping you doctor, so and so, asides from you,
who is closing me? That's right? And nine out of

(11:33):
ten times, nine out of ten times it will be
the tech. The tech you mean the guy who answered
them instruments. Yeah, the tech. Isn't that illegal? Yeah, it's
illegal in California. It's illegal for a tech to close.
I guarantee you if you walk around to every single
OAR in Beverly Hills and beyond, techs are closing tons

(11:56):
of patients. If you're lucky, and I mean if you're lucky,
your surgeon will close the right breast while your tech
closes the left breast. But that's not usually the case
because if they're really busy and they're good, they're gonna
put a few key sutures. Have a tech close both
sides or two tech clothes while the surgeon is in
the next room getting the next patient marked and ready
to go. That is correct. You heard me right. The surgeon,

(12:20):
the person you interviewed and paid, who was millions of
followers and is famous for the card. That person is
not closing your incision, which is the single most important
thing in plastic surgery. So I, for twenty years, God
is my witness, have closed every single incision in every

(12:43):
single patient since the day I started practice. And I
do body lifts, circumferential body lifts, thigh lifts, arm lifts,
tummy tucks, breast reductions, everything as a result, it takes
me almost twice as long to do things, because I'm
the one sowing the right breast, and then I'm sowing
the left breast, and then I'm sewing the abdomen, and
so on and so forth. The next question is not

(13:04):
who's closing, how are they closing? What do you mean?
How many layers of sutures? So we talked about tension,
So you cut it open and you can bring it
back together. When I close, I close every layer of
that incision independently. In other words, I close the deep
scarpus or the deep layer. I close this superficial layer,

(13:30):
the dermis, and then I close the skin. I do
that individually, sut your one level suit, your next level suit,
your next level. Then I put those sutures so close
to each other, in other words, one here, one less
than a centimeter, less than a centimeter less than a centimeter,
as opposed to one an inch later, an inch later,
an inch later. Why is all that closure necessary? I

(13:52):
don't know if any of you have heard of Gulliver's travels.
So the idea is there's this huge giant and next
thing you know, he's been lifted and moved by a
million little putis The little putians are tiny little people.
How the hell do they move the giant because millions
of them moved them. The idea being is when you
have tension and you distribute it by many areas, then

(14:18):
no one area carries the tension. So if your goal
is to have a beautiful scar, you need multiple layers
very close together to decompress the incision, not to mention.
You want it to be smooth rather than dipped in
like a sea section. If a woman has a sea section,
she'll tell you is always a little pucker or a

(14:39):
little dent in a scar. Why is it denting? It's
denting because instead of closing all the layers and reinforcing
the scar, the layers below haven't been closed or closed well,
and the scar contracts and pushes inwards and you get
a little divid So how many layers, how far apart?

(15:01):
The type of suture, so we have little tiny sutures
and we have thig honking sutures. Well, obviously, as the
layers are deep, you need thicker suture because they're deep
and that's what's holding everything together. And as you go
higher and higher, it should get smaller and smaller because
the smaller the suture, the less inflammation it causes. So

(15:26):
how many layers, how far apart? What type of suture?
Now this part is crazy. In addition to closing everyone myself,
the last layer, which is the skin layer, can be
closed million ways. One way is with staples, one way
is with glue. Right, kids, people go in the er.
My son lacerated his brow. I sewed my son up,

(15:49):
and I sewed them with permanent suture with them had
to be removed. When you go to new Yer today,
they're gonna bring it together, glue it and call it
a day. The last layer can be run with an
absorbable suture that runs inside of the skin. Well, what
do you do, doctor Rabond? Since you sound like you
think you close best the last layer, the skin, the

(16:10):
last connection. I sew together every case with a suture
called six o nilon. And what's the story with six
on nilon? Six on nilon is a suture that I
use during eyelid surgery. It's that fragile. It is the
caliber of your hair. Mean, it's like so thin. It's permanent,

(16:32):
which means I have to put it in and five
days later later take it out. Why on Earth? Would
you do that? Well, I do it because it makes
perfect reapproximation. And then since I take it out, there's
no inflammation left behind. When you use an absorbable suture, well,
where the hell do you think it goes? It absorbs,

(16:53):
doctor Rabon, How does it absorb? I don't know through inflammation.
Inflammation is the bodies way of absorbing sutures. Now, down deep,
it's okay, but right under the skin surface you don't
want inflammation. So I actually put a permanent suture in
long enough for the edges to come together, but then

(17:15):
take it out. So in the world of body surgery,
that's bananas. The fact that I close myself bananas. The
fact that I put multiple levels of sutures individually so
close together, bananas. The fact that I closed with six
zo nylon on a body lift or a thigh lift
or a breast reduction or a breastlift, crazy bananas. And

(17:36):
then it needs to be removed a week later. Do
you guys think I enjoy closing like it's some hobby
or fun or wooh, I can't wait to I hate clothing.
It's not fun. No one likes it. If it was fun,
surgeons would do it. The reasonsurgeons don't do it. It's tedious,
it's time consuming. I have a trigger finger in my
right middle finger, I am fifty one years old, and

(17:59):
I'm achy. I do it because it's the right thing
to do. I do it because while my scars are
not perfect and invisible, I think my scars are unarguably
better than ninety percent of surgeons because of the extra time.
Not because I'm some magician or I have some unique
technique that only I invented. It's because I'm willing to

(18:21):
take the time to do it, and nobody else wants
to do it, because fuck, who the hell wants to
stay in surgery when I can move on to another patient.
So I want you all to listen to what I
just said to you. Do not be fooled by anything
else that's being told you than other than closure. Educate yourself.
Understand that no matter what, if your closure is shitty,
your scar will be shitty, and there's no way of

(18:43):
getting around that. The last part of your ultimate scar
is the aftermath or the aftercare. So we said who
you are, could be good, could be bad, can't be changed.
How you're closed, which can absolutely be amazing or shitty
and then after care. Aftercare is less than one percent

(19:03):
of the outcome. What are you talking about? Aftercare? Lasers,
scar cream tapes, this that snake oil, this sand from
the desert of Sahara, blah blah blah blah blah. All
that is garbage. Surgeons love to sell you on aftercare.
So what they say is, oh, when you do a
tummy tuck with me, we have a scar management protocol

(19:26):
or some something that we do. That's just nonsense. Why
don't you just close the incision? Well, take the time,
and then I don't need all this mickey mouse crap.
If lasers and creams and lotions and all this nonsense worked,
I would simply have my tech clothes and laser the
shit out of you afterwards. Why wouldn't I do that?

(19:48):
It doesn't do squat. Once you have a shitty scar.
All that stuff isn't going to do nothing, it's sure,
and the last thing you want to do is injected
with steroid or something crazy that at the end of
the day, there's no shortcut to it. It comes down
to time. Like tapestry or a beautiful Persian rug, or

(20:10):
some needlework or some painting that took months, or chiseling
down a piece of stone into a gorgeous statue. All
things that are worth it take time. There's no shortcuts,
and I assure you if there was, I would have
figured it out because I'm no hero. If I can

(20:31):
get you a great outcome and do half the work,
trust me, I am all for it. So let there
be no confusion. The number one most important thing in
plastic surgery is what will my scars look like? It
is down to three key elements. Who you are, what's
done during surgery, and what you do afterwards. Who you

(20:51):
are is who you are. You can't change it. What's
done during surgery is all about your surgeon and his
or her willingness to take the time and do something well.
And aftermath makes almost no difference. So hopefully that's clear
and you can take that wherever you go. Oh I'm
about to have a C section. Oh I'm about to
have my gall badder move, Oh I'm about it doesn't

(21:12):
matter what the scar is, A scar is a scar
is a scar at any rate. That's my spiel. I've
said it a thousand times on Instagram, TikTok, YouTube podcasts
in the past and I'll just keep saying it over
and over again because obviously it's not very popular because
then surgeons are like, oh shit, he's telling everybody the truth.
Now I have to operate and do the extra work.
I'm to be honest with you, I don't want it anyways. Guys,

(21:34):
that's a wrap as always. I'm your host, doctor Roddy Rabon.
I hope you enjoy that podcast. If there's two things
I can ask you, I would be grateful. One is
if you can you enjoy the show. You found it interesting,
go write a review. Write something nice right now. Write
the second literally, just as you're listening to this podcast,
pull up the write a review part and write something nice.

(21:55):
Everyone here is working hard, so you have a cool
episode once a week. And the other's forward this episode.
Vote all our episodes to people you love, your friends,
your family because you think you like they'll tell you
if you're about to have plast surgery're like, oh, let
me tell you something. You don't know. They're gonna do
plast surgery till it's too late, and at that point
then you're gonna wish you had sent them the information. Okay,

(22:15):
So that's a wrap, as always, I'm your host, Doctor
Rody Raman, and I look forward to yet another episode
of Plastic Surgery Uncensored.