Scars can affect your appearance and movement and how you feel about them can be a very personal matter. Our surgeons will improve the appearance of your scar and increase function that was limited by it.
Scars remain after a wound from injury or surgery has healed. Many scars may become less noticeable with time so it may be recommended to wait at least one year before having scar revision. No scar can be removed completely, but they can be made less noticeable through scar revision.
There are many variables that affect the severity of a scar:
- Size and depth of a wound
- Blood supply to the area
- Thickness and color of your skin
- Direction of the scar
- Location of the scar
We want you to be informed before making your choices. Our caring team will take the time to listen to your needs and fully explain everything. We will develop a personal plan customized for your needs. You can feel confident in our excellent care.
Your surgeon will discuss the options available based on your scar. The discussion will include:
- Type of scar
- Surface treatments
- Surgical techniques
Type of scar
There are different treatments for scar revision based on the type of scar you have.
Surface irregularities – include discoloration and other subtle scars, but do not affect function or cause pain. These scars can be caused by acne, minor injury or surgical incisions.
Keloid Scars – thick, puckered, itchy clusters of scar tissue that grow beyond the edges of the wound or incision. They are often red or darker in color than the surrounding skin. Keloid scars can appear anywhere on the body, but are most common over the breastbone, on the earlobes and shoulders. They are often treated with a steroid medication injected into the scar. If the steroid treatment does not work, the scar may be surgically cut out. Keloid scars are known to recur, sometimes coming back even larger than before.
Hypertrophic Scars – thick, red and raised, but remain within the boundaries of the original incision or wound. They are very similar to keloid scars. Hypertrophic scars often improve on their own or with a steroid application or injection. They can also be improved surgically if needed.
Contractures – restrict movement due to skin and underlying tissue that pull together during healing. This can happen with a large area of skin loss from a burn or other injury. The contracture may restrict normal movement by affecting the adjacent muscles and tendons. The most common treatment for a contracture is cutting out the scar and replacing it with a skin graft or flap. Other techniques also include a Z-plasty or tissue expansion.
Some scars can be treated with non-invasive or surface treatments. These treatments will soften the surface of the scar or reduce uneven pigmentation. These options include:
- Dermabrasion – to soften facial scars, the top layers of the skin are scraped leaving a smoother surface, but it won’t completely remove the scar.
- Laser or light therapy – changes the surface of the skin to allow new, healthy skin to form at the scar site.
- Chemical peel – to soften the texture and color of a scar, a solution is used to penetrate the skin’s surface.
- Skin bleaching – medication is applied to the scar to lighten the skin.
- Cortisone injections – into the scar tissue, helps the scar tissue shrink and flatten out so it is less noticeable.
The type and extent of the scar will determine the scar revision procedure. Your surgeon will determine the best technique for your scar which may or may not include the following procedures.
Z-plasty – repositioning a scar to more closely conform to the natural lines and creases of the skin. This will make it less noticeable and can also relieve tension caused by contracture. The old scar is removed and new incisions are made on each side, creating small triangular flaps of skin. The flaps are then rearranged to cover the wound at a different angle, giving the scar a “Z” pattern. A portion of the scar will still remain outside the natural lines of the skin.
Skin grafting – transferring the skin from a healthy part of the body to cover the injured area. When new blood vessels and scar tissue form in the injured area, the graft is said to “take”. All grafts leave some scarring at the removal and injured areas.
Flap surgery – skin, underlying fat, blood vessels and sometimes muscle is moved from a healthy part of the body to the injured area. Sometimes the blood supply remains attached at the original site, and other times, the blood vessels are reattached at the new site using microvascular surgery.
Skin grafting and flap surgery improve the function of the scarred area, but the skin may not precisely match the color and texture of the surrounding skin.
Each scar revision procedure is based on an individual’s body and goals. We would be happy to schedule a consultation to answer any questions you may have and provide our recommendation on what we think is best for your situation. You will be well taken care of at Cosmetic Plastic Surgeons. We are confident you will be pleased with the results.