Scarring

Scarring is the natural end result of the healing process following injury to the skin, including lacerations, burns, infection, acne and surgery. When there is a break or insult to the skin, the skin itself is able to employ a biological process which helps to repair the damaged tissue and restore integrity to tissues. This occurs in multiple stages and the final stage is referred to as ‘remodelling’; it is during this phase that the established scar tissue matures. The aim of the scar is to bridge any separation in the skin to prevent infection and restore the skin’s natural properties. Scar tissue is created by a variety of special cells within the skin, including fibroblasts, which lay down connective tissue, including collagen, that form a bridge-like structure for new skin cells to grow around.

Unfortunately, this process does not always form a scar that is congruent with the surrounding skin and this can become problematic. Depending on the amount of collagen and pigment laid down, the resultant scar may appear:

Bulky or raised
Dimpled or depressed from the surrounding skin
Stretched
Tight and stiff in texture
Darker or lighter in colour than the original skin tone

Sometimes scar tissue can cause long term symptoms of discomfort, pain and itch. Scars that are particularly tight or tough can also cause problems with movement if located overlying a joint (e.g. elbow or knee).

Some people will have a tendency to develop troublesome scarring. For example, those with darker skin tones or strong family history are more likely to develop hypertrophic or keloid scarring in response to skin injury. Individuals who are known to have connective tissue disorders, such as Ehlers-Danlos syndrome, are at higher risk of atrophic (depressed) scarring. People who suffer from certain skin problems, such as extensive acne, are also at risk of developing adverse scarring, if the primary skin condition is not well managed in the first instance.

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About this condition

In addition to the physical factors around scars, there are a number of psychological, social and functional considerations for individuals who have experienced adverse scarring. It is known within the medical community that unfavourable scarring can be associated with poor self-esteem, mental health problems as well as functional limitations. It is beneficial to address scarring from all of these aspects in order to confer the most treatment benefit to each individual.

There are a number of treatments available for problem scarring, including the use of medicated tapes or plasters, injections, laser therapies, needling and surgical options. There is also a range of good moisturisers and camouflage products that can be of benefit. In those who are at a higher risk of developing adverse scarring, it can be beneficial to avoid any non-essential cosmetic or surgical procedures, which may cause scarring in the first place. In the case of necessary surgery, additional steps can be taken by an experienced and skilled surgeon to increase the chances of favourable scarring. These include tension-relieving suturing methods and employing additional post-procedure adjuncts to promote aesthetic healing, such as steroid tapes or needling.

Mr Ioannis Goutos is a London-trained and based plastic surgeon with a particular expertise in the assessment and surgical and non-surgical management of scars and burn injuries. He places special emphasis on the functional and psychodynamic aspects of scarring, to better give each individual fully holistic care. He is well known within the academic community as a leading expert on managing scars and burns, and has work published and presented both nationally and internationally.

Testimonials

Mr Goutos is delighted to share some of his patient and peer feedback on their experiences of his services.

Louise Steel

2023-08-16

Mr Goutos performed keloidectomy surgery on both my earlobes, and I am so grateful to have been referred to him. From the first consultation, through surgery, and now my 3-month follow-up, I have nothing but good words to say.

Luke Ward

2023-07-10

This man is an extremely intelligent, professional gentleman. He will set realistic expectations from the beginning and will not ‘beat around the bush’ so-to speak. From the initial consultation to post-surgery, it has been a rollercoaster ride. However the high level of expertise & professionalism Mr Goutos maintained has been impeccable. All I can say to any other individual considering treatment with Mr Goutos, is that you are in incredibly safe hands. And on top of this, he has a great sense of humour. I wish nothing but the best for this man, and the best results for his future patients.

Mauricio Lucas

2023-07-06

Outstanding Doctor - Exceptional Expertise I recently had the pleasure of consulting and also going through surgery. Dr. Goutos removed a large class of keloids from my back and chest, and without a doubt, I can confidently say that he is the best doctor I have ever had the privilege of seeing. From the moment I entered his practice, I was immediately struck by his professionalism, knowledge, and exceptional bedside manner. Dr. Goutos possesses an extraordinary level of expertise in his field, and his technical skills are truly remarkable. His ability to diagnose and treat medical conditions is unparalleled, and I have personally witnessed his remarkable success in improving the health and well-being of countless patients. What sets Dr. Goutos apart is his genuine care and concern for his patients. He takes the time to listen attentively, ensuring that he understands every aspect of the medical issue at hand. He communicates clearly and effectively, explaining complex medical concepts in a way that is easy to comprehend, which greatly helps in alleviating any concerns or fears. One aspect that impressed me greatly was Dr. Goutos' commitment to staying updated with the latest advancements in his field. He incorporates cutting-edge techniques and treatments into his practice, ensuring that his patients receive the highest standard of care available. This dedication to continuous learning and improvement is a testament to his unwavering dedication to his profession. Additionally, the support staff at Dr.Goutos' practice deserves recognition for their exceptional service. They are friendly, compassionate, and highly efficient, ensuring that appointments run smoothly and patients feel comfortable throughout the entire process. Overall, I cannot emphasize enough how fortunate I feel to have found Dr.Goutos' exceptional skills, genuine care, and unwavering commitment to his patients make him a truly outstanding specialist. I wholeheartedly recommend him to anyone seeking top-notch medical care.

Kashmala Khan

2023-01-26

Mr. Goutos and his team did an amazing job reversing a scar I had on my forehead. This was a very old scar and had bothered for many years. The laser treatment and fat transfer procedure has changed my life and given me so much confidence. I would definitely recommend him, he is a fantastic and very skilled surgeon. Thank you so much!

Javier

2023-01-14

Mr Goutos and his team removed some lipomas from my arms. The initial consultation right through to the aftercare was professional, sensitive and genuine. Mr Goutos put me at ease right from the start, discussing my history and background and then discussing the various options for the incisions and sutures. The incisions were quick, efficient and professional. I felt completely at ease knowing I was in expert hands. The incisions were extremely neat and have closed and scared really well. I had a number of questions after the operation and one of the sutures became infected. Mr Goutos was quick to make an appointment for me, see me and deal with the infection and offered for me to see him again if the infection didn’t calm down. He was genuinely empathetic to my needs and took time to check each scare, explain things and assure me along the way. He didn’t at any point, make me feel I was asking silly questions or too many. I highly recommend Mr Goutos for his exceptional incisions and suturing as well as his professional conduct, caring approach and after care. The whole experience was smooth and easy and I am very grateful for what he has done for me.

Ieva Lihovida-Yarlett

2022-12-07

We came to see Dr Goutos a few month ago to remove invasive spider nevus on my 9 year old sons nose . After a lovely consultation with Dr Goutos , he suggested to do several laser treatment sessions. After a few sessions we already noticed a massive improvement. On the final laser treatment session the spider nevus was completely gone. Thank you to the Dr Goutos for tackling the problem so rapidly and with great results!

Amy Munson

2022-10-27

We took our 4yr old daughter to Mr Goutos following an accident which resulted in a small burn scar on her cheek. Mr Goutos gave us various options and we went for laser treatment. After 4 appointments the scar has gone! The care that Mr Goutos gave us was exceptional and so good with children. He made us feel very comfortable and confident in his ability. I would recommend him to anyone if they were looking for a doctor in that particular field. Can't thank him enough.