Scar revision surgery is meant to minimize the scar so that it is more consistent with your surrounding skin tone and texture.
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 treatment options may vary based on the type and degree of scarring.
Although scar revision can provide a more pleasing cosmetic result or improve a scar that has healed poorly, a scar cannot be completely erased.
Procedural Steps
Anesthesia
Medications are administered for your comfort during the surgical procedures. The choices include local anesthesia, intravenous sedation and general anesthesia.
The different treatments
The degree of improvement that can be achieved with scar revision will depend on the severity of your scarring, and the type, size and location of the scar.
Topical treatments, such as gels or tapes can be used to treat new or existing scars.
Injectable treatments 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. One form of injection therapy uses steroid-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 mechanically removing the top layers of skin. 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.
For deeper scars an incision may be needed to surgically remove the old scar.
Some scars require excision and layered closure. Layered closure is often used where excision extends to tissue below the skin surface or in areas with a high degree of movement. Absorbable sutures are placed below the skin to help keep the scar more narrow.
Advanced techniques in scar revision include complex flap closure to reposition a scar so that it is less conspicuous, or improve flexibility where contracture has restricted mobility.
Scar revision surgery risks
The decision to have scar revision surgery is extremely personal and you’ll have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable.
Some of the risks include:
- Bleeding (hematoma)
- Infection
- Delayed healing
- Anesthesia risks
- Change in skin sensation
- Damage to deeper structures including nerves, blood vessels, muscles and lungs can occur and may be temporary or permanent
- Allergies to tape, suture materials and glues, blood products, topical preparations or injected agents
- Skin contour irregularities
- Skin discoloration and swelling
- Skin sensitivity
- Deep vein thrombosis, cardiac and pulmonary complications
- Pain, which may persist
- Possibility of revisional surgery or staged procedures