Scars Revision

Living with scars?

While there are no medical or surgical method that can remove a scar completely, there are surgical techniques that may be used to treat problematic scars.

Scars may become a problem when they:

  • Alter a person’s appearance, making them feel less attractive or self-conscious
  • Impair movement or mobility
  • Cause pain
  • Cause intense itching and inflammation

Many factors will influence the quality of a scar and include;

  • The nature of the injury or surgery causing the scar,
  • The location of the scar
  • The person’s innate wound healing properties,
  • Cultural background,
  • Disease states,
  • Smoking,
  • The technique of wound repair and the presence of any complications during the wound healing phase.
  • Hypertrophic scars – raised and red scars that are usually itchy and sometimes painful.
  • Keloid scars – similar to hypertrophic scars but tend to grow beyond the edges of the original wound. These scars can become thick, puckered and firm. They can also be itchy or painful.
  • Contractures – often results from burns and injuries where large areas of skin were lost. They can severely restrict movement and mobility.
  • Facial scars – include acne scars as well as traumatic scars. Due to their location on the face, these scars can affect a person’s appearance and self-esteem.

There are several ways to improve the appearance of scars. These may include:

  • Removing the scar and repairing the wound again;
  • Re-orienting the scar direction to make the scar less obvious;
  • Bringing in new skin, by skin grafts or “flaps” to relieve tension across the scar.
  • Excision: is where the scar is cut out and repaired with one or more layers of stitches, aimed to produce a thinner less noticeable scar.
  • Z-Plasty or W-Plasty: are procedures designed to re-align the scar tissue, particularly where a scar lies across a skin crease or where constractures have resulted from injuries, such as burns. 
  • Skin graft and flap surgery: are more complex procedures than other forms of scar revision. This form of surgery is usually for scarring that involves large areas of skin and for constractures that restrict movement or cause severe pulling of the surrounding skin. Skin grafting involves taking a piece of normal skin from a healthy part of the body (the donor site) and placing it on the area where scar issue has been removed. Flap surgery is more complex than skin grafting as it involves the transfer of healthy skin with fat, blood vessels and sometimes muscle still attached, from the donor site to the injured area.

Depending on the size of the scar, the surgery may be performed under local anesthetic for smaller scars and general anesthetic for more major scars.There are occasionally non-surgical options such as laser or skin needling which may improve the appearance or take some of the redness out of the scars.

  • In a sutured wound, during the first two weeks the basic scar is formed.
  • During the next 8 weeks the scar overgrows (proliferates). At the end of the proliferative stage the scar is red, slightly raised and somewhat lumpy.
  • It takes approximately 6 to 12 months from the time of injury or surgery for a scar to fully mature.
  • A mature scar is pale or white, soft and flat. (Younger the age of the patient, longer the time to mature.) The new scar after a scar revision surgery will look better in most instances but may look almost the same in other instances.
  • Some types of scars have much better chance for improvement by surgery than other types of scars.
  • Some areas of the body form better scars after surgery than others. These facts are taken into consideration when a decision is made for a scar revision surgery.
  • Hypertrophic scars are the ones which continue to grow and look red, raised and lumpy.
  • COMMONLY ASKED QUESTIONS

Will I need anaesthesia?

Depending upon the procedure, general or local anesthesia may be used. Modern anesthesia is safe and effective, but does have some risks. Ask your Specialist Plastic Surgeon and anesthetist for more information. Your surgeon and/or anesthetist will ask you about all the medications you are taking or have taken, and any allergies you may have. Make sure you have an up to date list before the surgery.

Where will the surgery take place?

Depending upon the extent of the procedure, scar revision surgery can be performed either as a day case or alternatively with a short hospital stay. Your Specialist Plastic Surgeon will advise on the best option for you.

Initially you should have a detailed consultation at Profile Perfection to discuss the different types of scar revision options available to you. Together we can discuss the options of which surgeons are specialized in this type of procedure and organize a consultation with the surgeon.Once all of your questions and queries have been answered and you are ready to go ahead with the procedure we can start your journey. You will have a high level of support from beginning to end.Having a procedure can be very daunting and you will feel that you do not know which procedure will be best for you? Which surgeon should I choose? Who will answer all of my questions when I get worried? What questions should l ask the surgeon?At Profile Perfection we will support you and your decision, guiding you from the initial consultation all the way through to recovery.

 

 

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