Understanding scar revision
Scars are a natural part of the body’s wound-healing process, but not all scars heal similarly. Some scars are barely noticeable, while others can be more prominent and affect appearance and function. Scar revision is a surgical procedure designed to improve or reduce the appearance of scars and, in some cases, restore function to the affected area. Whether the scar resulted from an injury, surgery, or another cause, scar revision offers various treatment options to address the issue.
Types of scars
Before diving into scar revision treatments, it’s essential to understand the different types of scars. Scars can vary in appearance, texture, and severity, and each type may require a specific approach to treatment.
- Hypertrophic Scars: These scars are raised, red, and often itchy, but they remain within the boundaries of the original wound. They are more common in areas of high skin tension, like the shoulders or chest.
- Keloid Scars: Unlike hypertrophic scars, keloid scars extend beyond the original wound site. They can be large, raised, and painful. Keloids are more common in darker skin tones and certain areas of the body, such as the earlobes and chest.
- Acne Scars: These scars can range from deep pits to shallow depressions or raised scars, often resulting from severe acne. They can significantly affect the skin’s texture and appearance.
- Contracture Scars: These occur when the skin “shrinks” as it heals, often after burns, leading to tightness that can affect movement, especially if the scar is near a joint.
- Atrophic Scars: These are sunken scars that form when underlying structures like fat or muscle are lost. Common examples include scars from chickenpox or severe acne.
Why are some scars so prominent?
Several factors influence why some scars are more noticeable than others. The wound-healing process plays a critical role, as much as the location of the scar. Areas under constant movement or tension, such as joints or the chest, tend to develop more prominent scars. The size and depth of the original injury or incision also matter—larger, deeper wounds are more likely to result in noticeable scars.
Other factors include:
- Genetics: Some people are more prone to developing raised scars like keloids.
- Skin Type: Darker skin tones have a higher risk of developing keloid scars.
- Age: Younger skin tends to heal more quickly, which can lead to more noticeable scarring.
- Previous Surgery: Scars from prior surgeries can influence the formation of new scars.
Many healthcare providers would look at the reasons behind your scars during the initial consultation, as it comes in handy when deciding if scar revision surgery is possible, and if so, which scar revision procedures are suitable for you.
Scar revision treatment options
Scar revision is not a one-size-fits-all approach. The treatment plan is tailored to the individual’s specific scar type, location, and personal preferences. Here are some common scar revision techniques:
Surgical Treatment: For severe scars, surgical intervention might be necessary. Scar revision surgery involves making a new incision along the scar line and carefully removing the old scar. The wound is then closed in a way that minimises the visibility of the new scar, often aligning it with natural skin creases.
Some techniques used include:
- Z-Plasty: A technique where the scar is repositioned to follow natural skin lines, making it less noticeable.
- W-Plasty: Used to break up a straight scar line, making it blend more with the surrounding skin.
- Flap Surgery: In cases where the skin is tight, a skin flap from a nearby area may be moved to cover the scar site, improving both function and appearance.
- Skin Grafting: This involves taking healthy skin from another part of the body to cover the scarred area, often used in burn scars.
Laser Therapy: Laser therapy is effective in reducing the appearance of various scars, including acne scars. It works by removing the upper layers of the scar tissue and stimulating the production of new, healthy skin cells. Lasers can also help improve the colour and texture of raised scars.
Steroid Injections: Corticosteroid injections are particularly useful for treating hypertrophic scars and keloids. These injections reduce inflammation and flatten raised scars over time. Injections may need to be repeated over several months for the best results.
Dermabrasion: Dermabrasion is a technique that sands down the top layers of skin, smoothing out uneven scars and improving their appearance. It’s often used for shallow scars, including those left by acne.
Pressure Therapy: Pressure therapy involves applying pressure to the scarred area using specialised garments or bandages. This technique is commonly used for burn scars to flatten and soften the raised tissue.
Topical Treatments: Topical treatments, such as silicone sheets or gels, can help reduce the appearance of scars over time. These treatments are particularly effective for newer scars.
Tissue Expansion: In some cases, a balloon-like device is inserted under the skin near the scar. This device is gradually inflated, stretching the skin and allowing for the excision of the scarred area and replacement with healthy skin.
Click here to speak to our team to find out which treatments we offer at Goutos London for scar revision procedures, and why we believe them to be the first-class option!
What to expect after scar revision
After a scar revision procedure, it’s essential to have realistic expectations. While the goal is to improve the scar’s appearance, complete removal is often impossible. However, scar revision can significantly improve the scar’s appearance, making it less noticeable and improving skin texture.
The recovery time varies depending on the type of scar revision treatment you undergo. For surgical treatments, stitches may be removed after a week or two, but full healing can take several months. Laser therapy and steroid injections may require multiple sessions, with gradual improvement over time.
Potential risks
As with any surgical procedure or medical treatment, risks are involved no matter how careful and diligent you have been. Some of these risks, albeit unlikely, are blood clots, infections and an adverse reaction to general or local anaesthetic. There’s also the possibility of developing a new scar, though this is typically less noticeable than the original scar.
During the first consultation, it is vital to make sure you can handle local or general anaesthesia. If there are any concerns, then other treatments should be considered.
Post-revision care and results
Your healthcare provider will give you specific instructions on how to care for the scar site after the procedure. Avoiding sun exposure, applying prescribed ointments, and avoiding activities that might stress the wound are some suggestions you may hear.
It’s important to note that scars continue to heal and change for up to a year after scar revision. The final appearance of a scar can take time to develop, and ongoing treatments may be necessary to achieve the desired results.
Scar revision offers a range of treatment options for improving the appearance of scars, from topical treatments to surgical procedures like skin grafting and flap surgery. By understanding the types of scars and the available scar treatments, you can make informed decisions about how to manage and reduce the visibility of your scars. Always consult with a qualified plastic surgery specialist to determine the best course of action for your specific needs and to set realistic expectations for the outcome of your scar revision treatment.
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