In the first week after keloid or scar surgery you should expect a dressing that stays on for a few days, moderate soreness that responds to simple painkillers, some swelling and bruising around the site, and clear instructions about keeping the area dry. Most people go home the same day or the next morning and manage ordinary daily activities within two or three days. This week is about protecting the wound and starting the measures that reduce the chance of the scar building up again. It is not the week in which you judge the final appearance.
What happens on the day of the procedure?
Depending on the size and site of the scar, the procedure may be done under local anaesthesia, a regional block or general anaesthesia. Afterwards you rest until the team is satisfied you are comfortable, eating and passing urine normally. A written estimate is given before admission, so there are no surprises about what was planned. You will be sent home with a dressing already in place, medication, and clear written instructions about what to do and whom to contact.
Arrange for someone to travel home with you if any sedation or general anaesthesia was used. Do not drive yourself on that day.
How much pain is normal in the first few days?
Expect a deep soreness rather than sharp pain, worst on the first and second day and easing steadily after that. Simple painkillers taken at regular times work better than waiting until it hurts. An earlobe or a small chest scar is usually mild. A larger release across a joint or an area that needed a graft is more uncomfortable and may ache for longer. If pain is increasing rather than settling after the second day, or is not controlled by the medication you were given, contact the clinic rather than doubling the dose yourself.
What should the dressing and wound look like?
The first dressing usually stays untouched for several days unless you are told otherwise. A small amount of pink or straw coloured ooze on the outer layer in the first day or two is common. Keep the area dry. Ask the team specifically when you may shower, because the answer differs depending on whether the wound is stitched directly, grafted or left with a drain.
At the first dressing change the wound often looks worse than people expect. Swelling, bruising, a raised firm ridge along the suture line and yellowish film on the surface are all part of normal early healing. Signs that need reporting the same day are spreading redness beyond the wound edges, increasing swelling, fever, foul smelling discharge, or a wound edge that has separated.
When do the stitches come out?
Stitches on the face and earlobe are usually removed early, while those on the chest, back, shoulder and limbs stay in longer because the skin there is under more tension. Some are dissolvable and need no removal at all. Your team will give you the date. Removing them too early risks the wound stretching, which is exactly the opposite of what you want with a keloid prone site, so keep the appointment you are given even if the wound looks settled.
Does treatment start again this early?
Often yes, and this is the part people do not expect. Because surgery alone has a high tendency to be followed by recurrence, the plan usually pairs it with other measures, and some of those begin within the first week rather than months later. Depending on your scar the team may arrange:
- An injection into the wound bed or the surrounding tissue at the time of surgery or shortly after.
- A pressure earring, clip or garment fitted once the wound allows it.
- Silicone gel or sheeting started only when the surface has fully closed, never on an open wound.
- Early radiotherapy in selected cases, which if planned is usually scheduled very soon after the operation.
Ask at your first review exactly which of these applies to you and on what date it begins. The benefit of these measures comes from doing them consistently for months, so understanding the plan in week one matters more than it seems.
What can you do and what should you avoid?
Gentle walking and light household activity are encouraged from the start. What you avoid is anything that stretches or drags on the healing line. That means no heavy lifting, no gym, no vigorous stretching of the treated area, and no swimming until you are cleared. If the scar is on the ear, sleep on the other side. If it is on the chest or shoulder, avoid tight straps and reaching overhead. Keep the area out of direct sun, because fresh scars darken easily in Indian sunlight and that pigmentation can last a long time.
Smoking narrows small blood vessels and interferes with wound healing, so stopping is one of the few things fully within your control that genuinely helps.
Will you be able to see any improvement yet?
Not fairly. At one week the area is swollen, the line is firm and red, and the surrounding skin may still be bruised. Scars follow a long course, and everyone changes at a different pace. Judging the result now is like judging a building from its scaffolding. The clinic will review you at intervals and compare photographs over months, and that is when meaningful change becomes visible.
When should you seek urgent help?
Go to an emergency department now if you develop a high fever with shaking chills, rapidly spreading redness, severe or sharply worsening pain, heavy bleeding that does not stop with firm pressure, or breathlessness and chest pain. For anything less alarming but still worrying, the clinic can be reached on WhatsApp and will tell you whether you need to be seen.
The first week asks very little of you beyond patience and protecting the wound. Keep the dressing dry, take the medication as prescribed, keep every review appointment, and start the adjuvant measures on the date you are given.
