Scar – Revision

Surgical scar revision can change the size of a scar; raise depressed scars or lower elevated scars and improving the appearance of a scar. While a scar’s colour cannot be altered, colour will usually fade in time.

Types of scar :

Keloid scars are a result of the skin’s overproduction of collagen after a wound has healed..Keloid scars are thick, puckered, itchy clusters of scar tissue that grow beyond the edges of the wound or incision. They are often red or darker in colour than the surrounding skin.

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.

Spread scars are widened and the skin is thinned.

Contracture scars are the most severe forms of a scar and usually occur as a result of a loss of a large area of skin. Contracture scars are most commonly found in patients that have experienced burn injuries.

Though a scar cannot be removed completely it is often possible to make it appear less obvious.We 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.

Ideal candidates :

Who feels that the scar is uncomfortable or self conscious

Who have realistic expectations for scar improvement

Who do not have active acne or skin diseases in the area to be treated

Who are physically healthy

Who are non-smokers

At First Consultation :

During the initial consultation, you should expect:

To provide a complete medical history, including information about previous surgical procedures; past and present medical conditions; and any medications or herbal supplements you are taking.

Your surgeon to conduct a complete physical examination.

To discuss possible risks and complications of the procedure.

Procedure :

Surgical Scar Revision:

During surgical scar revision, a scar is removed and the surrounding healthy skin is joined in a less conspicuous manner. Wide scars can often be excised and closed resulting in a narrower, less obvious scar; similarly, long scars can be shortened.

Z-Plasty :

Z-plasty is a surgical technique most commonly used to change the direction of a scar and, therefore, make the scar less visible. Scars that lie in the lines of facial expression tend to be less visible than scars that cross these lines of facial expression. The Z-plasty is used to put these scars in the lines of facial expression.

Steroid Applications and Injections :

Steroids can help flatten and reduce the redness of hypertrophic and keloid scars. Steroids are applied or injected into the scar. This is especially effective on hypertrophic and keloid scars and help to reduce the itching and/or pain associated with these scars.

Silicone Gel Sheets :

Silicone gel sheets can help flatten hypertrophic and keloid scars. These clear sheets are placed on the scar and worn 24 hours a day.

Dermabrasion :

Dermabrasionsmoothes out surface irregularities such as deep lines or scars by removing the topmost layers of the skin.

Tissue Expansion :

In this procedure, a “balloon” is inserted under a patch of healthy skin near a scar. The balloon is filled with a saline solution to stretch the skin. When the skin has been adequately stretched, which can take several weeks or months, the balloon is removed. The scar is then surgically removed, and the balloon-stretched skin is pulled over the previously scarred area and carefully closed.

Collagen Injections :

Collagen Injections are used to rise, or fill in, sunken scars.

Laser Skin Resurfacing :

There are two types of lasers used for reducing the uneven surface of scars: the CO2 Laser and the Erbium: YAG Laser. The CO2 laser is typically used for deeper scars, while the Erbium is used for superficial scars and deeper skin tones. Both lasers remove the topmost layers of skin, allowing new, smooth skin to form.

Instructions :

Take pain medication as prescribed. Do not take aspirin or any products containing aspirin.

Do not drink alcohol when taking pain medications..

Do not smoke, as smoking delays healing and increases the risk of complications.

Résumé normal activities gradually.

Avoid exposing scars to sun for at least 12 months.

Always use a strong sunblock, if sun exposure is unavoidable (SPF 30 or greater).

Keep steri-strips on; replace if they come off.

Keep incisions clean and inspect daily for signs of infection.

Keep area clean and dry first 24 hours.

No tub soaking while sutures or drains are in place.