Scar Revision

Scars are visible signs that remain after a wound has healed. They are unavoidable results of injury or surgery, and their development can be unpredictable. Poor healing may contribute to scars that are obvious, unsightly or disfiguring. Even a wound that heals well can result in a scar that affects your appearance. Scars may be raised or recessed, different in color or texture from surrounding healthy tissue or particularly noticeable due to their size, shape or location.


Your Options

  • Your treatment options may vary based on the type and degree of scarring and can include:
  • Simple topical treatment
  • Minimally invasive procedures (injectable treatments, surface treatments)
  • Surgical revision with advanced techniques in wound closure


Topical Treatments

Such as gels, tapes or external compression can help in wound closure and healing, or to reduce the ability of skin to produce irregular pigment. These products may be used to treat existing surface scars and discoloration, and to aid in healing of scar revision procedures.


Injectable Treatments

These are often used to fill depressed or concave scars. Depending on the injectable substance used and your particular scar conditions, results may last from three months to several years. Therapy must be repeated to maintain results. One form of injection therapy uses steroidal-based compounds to reduce collagen formation and can alter the appearance, size and texture of raised scar tissue.


Surface Treatments

Are most often used for cosmetic improvement of scars. These methods can soften surface irregularities and reduce uneven pigmentation. Surface treatments are a controlled means of either mechanically removing the top layers of skin or changing the nature of tissue. These treatment options include:

  • Dermabrasion is a mechanical polishing of the skin.
  • Laser or light therapy causes changes to the surface of the skin that allow new, healthy skin to form at the scar site.
  • Chemical peel solutions penetrate the skin’s surface to soften irregularities in texture and color.
  • Skin bleaching agents are medications applied topically to lighten the skin.

Scar Revision Surgery

Scar revision surgery is an important application of reconstructive plastic surgery. This is done to improve or reduce the appearance of scars, so that it is more consistent with your surrounding skin tone and texture. It also restores function, and corrects skin changes (disfigurement) caused by an injury, wound, or previous surgery.

Although scar revision can provide a more pleasing cosmetic result or improve a scar that has healed poorly, a scar cannot be completely erased.


Who Is a Good Candidate for Scar Revision Surgery?

Scar revision can be performed on people of any age and is a good option for you if: you are bothered by a scar anywhere on your body, you are physically healthy, do not smoke, have a positive outlook and realistic goals for your scar revision surgery , do not have active acne or other skin diseases in the area to be treated.

Problems that may indicate a need for scar revision include:

  • A keloid, which is an abnormal scar that is thicker and of a different color and texture than the rest of the skin. Keloids extend beyond the edge of the wound and are likely to come back. They often create a thick, puckered effect that looks like a tumor. Keloids are removed at the place where they meet normal tissue.
  • A scar that is at an angle to the normal tension lines of the skin.
  • A scar that is thickened.
  • A scar that causes distortion of other features or causes problems with normal movement or function.


How Should You Prepare for Scar Revision Surgery?

The initial consultation with your surgeon will require your complete medical history, so you will want to be prepared to provide the necessary information. You must be completely open and honest with your surgeon. If there is any medical problem, you will be referred to a specialist.

With all of this information, your surgeon can plan the best procedure for your needs and tell you how to adequately prepare for the procedure by giving you guidelines.

Before scar revision, the doctor may provide a list of medications that should not be taken because they enhance the possibility of bleeding like products containing aspirin, serotonin supplements and stimulants. Your doctor may also recommend that you take certain supplements, such as Vitamin K, to help with bruising and swelling.


How Is Scar Revision Surgery Performed?

Scar revision surgery works by repositioning the scar and making it appear totally inconspicuous. Depending on the extent of the surgery, scar revision can be done while you are awake (local anesthesia) or sleeping (sedated).


What Is Recovery Like After Scar Revision Surgery?

Some swelling, bruising and redness are generally unavoidable. For keloid revision, a pressure or elastic dressing may be placed over the area after the operation to prevent the keloid from coming back. For other types of scar revision, a light dressing is applied. Stitches are usually removed in 3 to 4 days for the facial area, and in 5 to 7 days for incisions on other parts of the body.

When you return to normal activities and work depends on the type, degree, and location of the surgery. Most people can resume normal activities soon after surgery. Doctors usually recommend that you avoid activities that stretch and may widen the new scar.

Avoid exposure to the sun for several months after treatment. Use sun block or a dressing (such as a Band-Aid) to keep the sun from permanently tanning the healing scar.

The end result of surgery is only evident after one year post surgery. While rates of healing vary widely and can sometimes be a source of worry, the final result is what matters most.


Will the Results of Scar Revision Surgery Be Permanent?

Generally, they are permanent, but keloid scars can recur.


What Are Possible Complications From Scar Revision Surgery?

When the procedure is performed by a highly qualified cosmetic surgeon complications are rare and usually minor. However, as with any surgery, there are potential complications and risks. Your physician will spend time discussing these with you during your scheduled consultation. Be sure to bring a list of questions or concerns with you.  All patients are instructed to discuss the general surgical risks with their surgeon.

While scar revision is normally safe, there is always the possibility of complications. These may include infection, bleeding, or the recurrence of an unsightly scar. Exposing the scar to too much sun may cause it to darken, which could interfere with future revision.