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Scar Revision / Minimize a Scar

Scar revision surgery is meant to minimize a scar so that it is more consistent with your surrounding skin tone and texture.

  • What is scar revision surgery?

    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 and can include:

    • Simple topical treatments
    • Minimally invasive procedures
    • Surgical revision with advanced techniques in wound closure

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

    Different scars require different treatments. A few common scars include:

    • Burn scars. Severe burns that destroy large sections of skin cause the skin to heal in a puckered way. As the skin heals, muscles and tendons may be affected in this "contracting" movement.
    • Keloid scars are a result of the skin's overproduction of collagen after a wound has healed. These scars generally appear as growths in the scar site.
    • Hypertrophic scars, unlike keloids, do not grow out of the boundaries of the scar area, but because of their thick, raised texture, can be unsightly and may also restrict the natural movement of muscles and tendons.
    • Facial scars can be unattractive simply because of where they appear on the face, while others affect facial expressions.
    • Discoloration, surface irregularities and other more subtle scars can be cosmetically improved by surgery or other treatments recommended by your plastic surgeon. These types of scars do not impair function or cause physical discomfort and include acne scars as well as scars resulting from minor injury and prior surgical incisions.

    The type of scar you have will determine the appropriate techniques your plastic surgeon will use to improve your scar.

  • Is Facial Scar Treatment for You?
    • The goal of facial scar treatment is to disguise the scar, relocate it, or minimize its prominence.
    • Different types of scars respond to different plastic surgery techniques. A person considering facial scar revision must understand that there is no way to remove scars completely.
    • Timing of surgery is another important choice. Some surgeons advise against any scar revision in cases of injury for a period that might extend up to a year after the injury. This interval allows the body enough time to heal fully.
  • Scar revision candidates

    Scar revision is a highly individualized procedure and you should do it for yourself, not to fulfill someone else's desires or to try to fit any sort of ideal image.

    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
    • You do not smoke
    • You have a positive outlook and realistic goals for your scar revision surgery
    • You do not have active acne or other skin diseases in the area to be treated
  • What happens during scar revision surgery?

    Following is a general description of the surgery. Remember, each patient's individual needs and features are considered before surgery.

    • When a scar is of the contracture type, surgery generally involves removing the scar tissue entirely.
    • Skin flaps, composed of adjacent healthy, unscarred skin, are then lifted and moved to form a new incision line.
    • Where a flap is not possible, a skin graft may be used. A graft involves taking a section of skin tissue from one area and attaching it to another. Time must be allowed following surgery for new blood vessels and soft tissue to form.
    • Z-plasty is a method to move a scar from one area to another, usually into a natural fold or crease in the skin to minimize its visibility. While Z-plasty does not remove all signs of a scar, it does make it less noticeable.

    Dermabrasion and laser resurfacing are methods a surgeon uses to make "rough or elevated" scars less prominent by removing part of the upper layers of skin with an abrading tool or laser light. Clearly, the scar will remain, but it will be smoother and less visible.

    Keloid or hypertrophic scars are often treated first with injections of steroids to reduce size. If this is not satisfactory, the scars can be removed surgically, and the incisions closed with fine stitches, often resulting in less prominent scars.

  • What to Expect After the Surgery

    Note: These are general guidelines. Please ask your doctor to fully explain what your expectations should be post-surgery.

    Scar revision can be performed on people of any age and is a good option for you if:

    • You can expect to feel some discomfort after facial scar revision surgery. Some swelling, bruising and redness are generally unavoidable.
    • It is important for you to follow your surgeon's after care recommendations. Though the sutures will be removed within days after the surgery, your skin needs time to heal.
    • Surgeons generally insist on decreased activity after surgery and instruct the patient to keep the head elevated when lying down, to use cold compresses to reduce swelling, and to avoid any activity that places undue stress on the area of the incision.
    • Depending on the surgery performed and the site of the scar, the facial plastic surgeon will explain the types of activities to avoid.
    • No medication should be taken without first consulting the surgeon. It is important to remember that scar tissues require a year or more to fully heal and achieve maximum improved appearance.
  • Scar revision recovery

    Progress and healing

    The initial healing phase of a surgical scar revision may include localized swelling, discoloration or discomfort and may take 1 to 2 weeks. Healing will continue for several weeks and as the new scar heals it will slowly refine and fade. With dermabrasion, chemical peel or laser resurfacing, you will experience similar conditions at the treated area, in addition to overall sensitivity.

    The results will be long-lasting

    The final results of your scar revision surgery will be long-lasting, however it may take several months for your final results to become apparent and in some cases it may take a year for the new scar to fully heal and fade.

    The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee, in some situations, it may not be possible to achieve optimal results with a single surgical procedure and another surgery may be necessary

  • Scar revision surgery risks and safety information

    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. Your plastic surgeon and/or staff will explain in detail the risks associated with surgery.

    You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo, the alternatives and the most likely risks and potential complications.

  • You will be given specific instructions that may include:

    How to care for yourself following surgery, medications to apply or take orally to aid healing and reduce the risk of infection, and when to follow-up with your plastic surgeon.

    When you go home

    If you experience shortness of breath, chest pains, or unusual heart beats, seek medical attention immediately. Should any of these complications occur, you may require hospitalization and additional treatment.

    Be careful

    Following your physician's instructions is key to the success of your surgery. It is important that the surgical incisions are not subjected to excessive force, abrasion, or motion during the time of healing. Your doctor will give you specific instructions on how to care for yourself.

    Follow all postoperative instructions carefully, including cleansing and at-home treatment regimens, and avoid sun exposure. Your cooperation will influence the outcome of your surgery.

  • Preparing for scar revision surgery

    Prior to scar revision surgery, you may be asked to:

    • Get lab testing or a medical evaluation
    • Take certain medications or adjust your current medications
    • Stop smoking well in advance of surgery
    • Avoid taking aspirin and certain anti-inflammatory drugs and herbal supplements as they can increase bleeding

    Special instructions you receive will cover:

    • What to do on the day of surgery
    • The use of anesthesia during your procedure
    • Post-operative care and follow-up

    Follow-up Care

    Follow-up care is vital for this procedure to monitor healing. Obviously, anything unusual should be reported to your surgeon immediately. It is essential that you keep your follow-up appointments with your surgeon.

  • Your scar revision consultation.

    The success and safety of your scar revision procedure depends very much on your complete candidness during your consultation. You’ll be asked a number of questions about your health, desires and lifestyle.

    • Why you want the surgery, your expectations and desired outcome.
    • Medical conditions, drug allergies and medical treatments.
    • Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs.
    • Previous surgeries.

    Your surgeon may also:

    • Medical conditions, drug allergies and medical treatments.
    • Examine your scar in detail
    • Take photographs for your medical record
    • Discuss your options and recommend a course of treatment/li>
    • Discuss likely outcomes and any risks or potential complications.
  • Questions to ask your plastic surgeon

    Use this checklist as a guide during your scar revision consultation:

    • Am I a good candidate for this procedure?
    • Where and how will you perform my procedure?
    • How long of a recovery period can I expect, and what kind of help will I need during my recovery?
    • What are the risks and complications associated with my procedure?
    • How are complications handled?
    • What are my options if I am dissatisfied with the cosmetic outcome of my scar revision surgery?
    • Do you have before-and-after photos I can look at for each procedure and what results are reasonable for me?

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