Stretched scars

Stretched scars are a particular type of scar that have a widened appearance once fully formed. Scars form following any injury or insult to the skin, such as a laceration, wound, surgical incision, self-harm injury or burn. As the injured skin heals, it undergoes a series of stages to repair itself and restore the skin integrity. In the final stages of scar formation, tough connective tissues, such as collagen, are laid down to give the skin mechanical strength. Stretched scars occur when the healing skin is exposed to mechanical stress. The tension across the healing tissue means that the collagen and connective tissues are laid down in a ‘stretched’ pattern, which may appear wider than the original wound. Stretched scars are typically flat or depressed from the surrounding skin and often pale in colour.

Stretched scars are similar to ‘stretch marks’ which are formed when the skin either expands or shrinks quickly (for example in rapid weight loss or gain or during pregnancy). This causes disruption in the connective tissues such as elastin and collagen within the skin resulting in the stretch marks, but there is no initial ‘break’ or injury to the skin itself.

Mr Ioannis Goutos is an expert plastic surgeon, with a particular academic and clinical passion for managing scars and burns. He has extensive experience in the assessment and treatment of individuals with troublesome scarring and is well placed to provide excellent surgical and non-surgical treatment options.

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About this condition

Stretched scars are thought to arise through 2 different mechanisms. If there are extrinsic tensions across the skin during early scar formation, the repairing connective tissues are laid down in a ‘pulled’ pattern to try and counteract this tension. Alternatively, if there is high tension across a wound causing the edges to come apart before the healing is complete (known as dehiscence), then the skin will continue to heal in a delayed manner (known as secondary intention). This will result in a widened appearance of the final scar. These processes typically occur in the early stages of scar formation and maturation, usually within the first 3 months of healing, although this ‘stretching’ process can continue for up to 1 year until the final scar is fully matured.

The skin contains natural creases and folds in its structure, which represent areas of lower tension within the skin. Stretched scars are more likely to occur if the precipitating wound or laceration is not aligned with these natural creases of the skin. Individuals who have connective tissue disorders, such as Ehlers-Danlos syndrome, are of advanced age or have sun exposure-related damage to their skin are at a higher risk of developing stretched scars. Due to the way in which they form, stretched scars are most likely to appear on the limbs (particularly overlying joints where there is higher skin tension), or on the face.

Stretched scars can be unsightly and cause individuals to feel self-conscious. There are a number of treatment options available to reduce the appearance of troublesome stretched scarring.

Stretched scars following surgery can be avoided with careful pre-operative planning of incision lines, wound closure using tension-relieving techniques and good post-operative care. This may include the use of compressive garments or supportive tapes or dressings whilst the wound is healing, as well as avoiding any strenuous activity which may put additional stress on the healing skin. If stretched scarring is already established, possible treatment options include:

Surgical revision of the scar (i.e. making small incisions in a ‘z’ shaped pattern to realign the tension within the scar)
Injections to increase the volume of the scar, making it appear more level with the surrounding skin

It is important to discuss all of the treatment options available with an experienced clinician, who will be able to advise you on the best treatment plan for you and your skin. In some instances, a combination of procedures can be employed to achieve an optimal cosmetic outcome.

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.