Scar Revision (Surgical)

Types of Scars

Keloid scars are thick, puckered, sometimes itchy clusters of scar tissue that can spread beyond the actual wound. They may be red or darker in color than the surrounding skin. They are most common in areas with underlying fatty tissue, and most prevalent in darker-skinned people.

Hypertrophic scars tend to be thick, red, and raised, but unlike keloid scars, they do not spread past the boundaries of the original wound. They may fade as time passes.

Atrophic scars depress into the skin, leaving holes or pockets. Acne can leave atrophic scars.

Contracture scarring may effect the adjacent muscles and tendons, restricting movement. It forms when skin and underlying tissues pull together during healing. (After a second or third
degree burn, for example.)

What Are Some Minimally Invasive Methods For Scar Revision?

Minimally invasive treatments may be used for the cosmetic reduction of minor scars.

• Microdermabrasion is a mechanical scraping of the top layers of the skin. It improves mild to moderate scarring and other superficial skin problems.  It  is often performed in conjunction with other skin renewal procedures.
• Non-ablative and ablative laser therapy are two major approaches for laser treatment of scars and stretch marks.
• Chemical peels produce shedding of the outer layer of skin, softening irregularities in color and texture and stimulating new collagen growth.
• Topical treatments (gels, skin bleaching agents, compression) smooth small scars or lighten them to match surrounding skin.
• Dermal fillers are injected into the scar area to fill in and smooth out depressions or concave scars.

Surgical Scar Revision

If large, deep, or unattractive scars are your concern, an incision may be needed. The old scar may simply be cut out and the incision closed with tiny stitches, leaving a finer, less noticeable scar.

Z-Plasty is a surgical technique that re-positions a scar so that it more closely matches the natural creases of the skin. It may also reduce the tension caused by contracture scarring. While it may make the scar less noticeable, it will not make it disappear completely.

W-Plasty is a similar technique in which the edges of a scar are trimmed in the shape of a W and closed in a zigzag fashion.

What To Expect After Your Surgery

After surgical scar revision, you may expect localized swelling, bruising, redness, or discomfort for 1 to 2 weeks. Although the stitches will be removed within days after surgery, healing of the new scar will continue for several more weeks. You may be advised to apply cold compresses to reduce swelling, to keep your head elevated while lying down, and to decrease or avoid certain types of activities. It is important to follow post-surgery instructions carefully.

As with any type of surgery, there are certain risks with scar revision surgery. You should discuss this with Dr. Gallacher before making any decision as to what treatment may be best for you.