SCAR REVISION SURGERY
About Scar Revision Surgery
You may consider having a type of surgery or a procedure known as Scar Revision if you’ve had scarring from a surgery or body contouring procedure, or perhaps an accident in the past has left you with a scar that you would like revised to help conceal. Scars are primarily caused when the body is injured and needs to repair itself. There are many different types of scars that can be formed and variations in the severity and deformity of each scar. A scar’s severity is dependent on the ways your body responds to injury, how it heals itself, and of course, how severe the injury was that caused the scar in the first place.
Scars are formed when the skin is cut, abraded (severely rubbed by friction), burned, or damaged in some way. The rebuilding of the damaged skin results in scarring, and everyone’s skin heals differently. Depending on the type of person or injury, some scarring may take the form of a Keloid Scar, a Hypertrophic Scar, or cause a Scar Contracture. The size, depth, blood supply to the damaged skin, thickness, and color of the scars all will affect a person’s decision to undergo Scar Revision Surgery.
Scar Revision Surgery can only improve the way the scar looks, rather than removing it entirely. No scar can be taken off completely. Our surgeons at Park Meadows Cosmetic Surgery can often improve the appearance of a scar, making it less obvious through the injection or application of certain steroid medications or through surgical procedures known as Scar Revisions.
A good step toward making an informed decision is to visit with one of our surgeons at Park Meadows Cosmetic Surgery. There are many different types of Scar Revision Surgery that we will discuss with you. The type of Scar Revision Surgery you have will depend on the severity of the scarring and your body’s response to the injury. Scar Revision may require injections, skin grafts, Z-Plasty or other methods in order to lighten or diminish the scar’s appearance. Remember that all scars are permanent. Scar Revision Surgery will not get rid of your scar, but it may help conceal it and improve its overall appearance.
Types of Scars
KELOID SCARS
Keloids 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 color than the surrounding skin. Keloids occur when the body continues to produce the tough, fibrous protein known as collagen after a wound has healed.
Keloids can appear anywhere on the body, but they're most common over the breastbone, on the earlobes, and on the shoulders. They occur more often in dark-skinned people than in those who are fair. The tendency to develop Keloids lessens with age.
Keloids are often treated by injecting a steroid medication directly into the scar tissue to reduce redness, itching, and burning. In some cases, this will also shrink the scar. If steroid treatment is inadequate, the scar tissue can be cut out and the wound closed with one or more layers of stitches. This is generally an outpatient procedure, performed under local anesthesia. You should be back at work in a day or two, and the stitches will be removed in a few days. A Skin Graft is occasionally used, although the site from which the graft was taken may then develop a Keloid.
HYPERTROPIC SCARS
Hypertrophic Scars are often confused with Keloids, since both tend to be thick, red, and raised. Hypertrophic Scars, however, remain within the boundaries of the original incision or wound. They often improve on their own—though it may take a year or more—or with the help of steroid applications or injections.
If a conservative approach doesn't appear to be effective, Hypertrophic Scars can often be improved surgically. Our surgeons at Park Meadows Cosmetic Surgery can remove excess scar tissue, and may reposition the incision so that it heals in a less visible pattern. This surgery may be done under local or general anesthesia, depending on the scar's location and what you and your surgeon decide. You may receive steroid injections during surgery and at intervals for up to 2 years afterward to prevent the thick scar from reforming.
CONTRACTURES
Burns or other injuries resulting in the loss of a large area of skin may form a scar that pulls the edges of the skin together, a process called contraction. The resulting contracture may affect the adjacent muscles and tendons, restricting normal movement.
Correcting a contracture usually involves cutting out the scar and replacing it with a Skin Graft or a Flap. In some cases a procedure known as Z-Plasty may be used. And new techniques, such as Tissue Expansion, are playing an increasingly important role. If the contracture has existed for some time, you may need physical therapy after surgery to restore full function.
Z-Plasty
Z-Plasty is a surgical technique used to reposition a scar so that it more closely conforms to the natural lines and creases of the skin, where it will be less noticeable. It can also relieve the tension caused by contracture. Not all scars lend themselves to Z-Plasty, however, and it requires one of our experienced surgeons to make such judgments.
In this procedure, the old scar is removed and new incisions are made on each side, creating small triangular flaps of skin. These flaps are then rearranged to cover the wound at a different angle, giving the scar a "Z"pattern. The wound is closed with fine stitches, which are removed a few days later. Z-Plasty is usually performed as an outpatient procedure, under local anesthesia.
While Z-Plasty can make some scars less obvious, it won't make them disappear. A portion of the scar will still remain outside the lines of relaxation.
Skin Grafting And Flap Surgery
Skin Grafts and Flaps are more serious than other forms of Scar Revision Surgery. They're more likely to be performed in a hospital as inpatient procedures, using general anesthesia. The treated area may take several weeks or months to heal, and a support garment or bandage may be necessary for up to a year.
Grafting involves the transfer of skin from a healthy part of the body (the donor site) to cover the injured area. The graft is said to "take" when new blood vessels and scar tissue form in the injured area. While most grafts from a person's own skin are successful, sometimes the graft doesn't take. In addition, all grafts leave some scarring at the donor and recipient sites.
Flap Surgery is a complex procedure in which skin, along with the underlying fat, blood vessels, and sometimes the muscle, is moved from a healthy part of the body to the injured site. In some flaps, the blood supply remains attached at one end to the donor site; in others, the blood vessels in the flap are reattached to vessels at the new site using Microvascular Surgery.
Skin Grafting and Flap Surgery can greatly improve the function of a scarred area. The cosmetic results may be less satisfactory, since the transferred skin may not precisely match the color and texture of the surrounding skin. In general, Flap Surgery produces better cosmetic results than Skin Grafts.
To learn more about whether your scar can be revised, we invite you to a schedule a consultation with one of our surgeons at Park Meadows Cosmetic Surgery. We would love to sit down and discuss with you the methods and options available to you to best help you reach your goals!
