Scar Revision

Scar Revision

Contents


Introduction to Scar Revision


The goal of scar revision is conceal or minimize scars through a variety of techniques. We can make wide scars more narrow and a raised scar more flat. We can also make a scar look irregular, instead of straight, which makes it harder to see.

Approaches & Techniques


Skin Resurfacing Treatments

Dermabrasion and laser skin resurfacing are effective techniques to remove the overlying layers of skin and scar to allow new skin to grow in its place. This is especially effective at smoothing out an area of scar that may have rises or depressions.

Serial Excision

Serial excision is a technique by which a large scar is partially removed over multiple sessions to gradually diminish the scar without creating too much tension or distortion to nearby areas.

Camouflage Techniques (e.g. W-Plasty, Z-Plasty, etc)

These techniques aim to change direction or irregularize a scar to make it better resemble a natural wrinkle or to make it more difficult to perceive.

Dermal Filler

An indented scar may be improved with traditional scar revision techniques described above, but a more simple solution with less downtime may be to inject dermal fillers in the region. This may elevate the scar to the level of the surrounding skin, thereby hiding it.

Planning Your Procedure


The Consultation

During the consultation, we will review with you the various options for revising your scar. We will also review your medical history and the history of your current concerns. We will also examine areas adjacent to the scar to determine the best technique for you.

Duration of Surgery & 
Anesthesia Options

Scar revision procedures usually take under an hour and may be performed in the office under local anesthesia.

Incisions

Incisions will vary according to the scar revision method. We do our best to conceal incisions in natural creases and wrinkles. 

How It's Done

For skin resurfacing, a dermabrader or laser is used to sand down any rasied areas and smooth the edges of any depressed areas. For serial excision, usually ellipses of scar tissue are excised within the larger scar. For camouflage techniques, the scar is excised and flaps of tissue are elevated. Once the camouflage technique has been performed, deep absorbable sutures are placed to relieve tension on the skin to reduce risk of a widening scar. Then the skin is closed with a combination of absorbable and nonabsorbable stitches.

Recovery

The typical at-home recovery time is 5-7 days. Immediately after surgery, light compression taping may be used to reduce swelling at the surgical sites. The compression taping is removed in 1-3 days. All stitches dissolve or are removed in 1 week.

Pain

The first night after surgery, you will feel a dull ache and tightness around the incision sites. Everyday thereafter, any discomfort will reduce significantly. It is normal to take opiate medication as needed up to a week after surgery, but most transition to regular Tylenol within the first week.

Swelling & Bruising

Swelling and bruising are expected and mostly subside in the first 2 weeks. Most bruising may be concealed with cover-up as it gradually fades. On average, 90% of the swelling subsides by 6 weeks after surgery, but it will take about 6 months for the incisions to feel soft again. In the end, all swelling and bruising will diminish.
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