Scar Revision

Treatment information

Generally about the treatment

Scars are unpredictable, regardless of whether they are caused by injuries, plastic surgery, or any other form of operation.

How the scar will develop depends on the healing ability of the patient's own body, but also on the qualifications of the doctor. There are many other things to take into consideration though, such as the size, depth, the blood flow to the area, the thickness, and the colour of the skin - as well as the direction of the scar.

Whether a scar is a problem or not depends on the person. Fortunately for those who feel bothered a scar, something can be done to help them.

Please note that a scar can never be removed completely, but a surgeon will often be able to improve the appearance of a scar, making it less visible. This can be done by an injection, with the use of special steroid drugs, or through a surgical procedure, also known as scar revision.

A scar will always be large and unsightly to begin with, but with time it becomes less visible. Because of this, many surgeons will recommend that the patient waits for a year or so from when the scar occurred, before having a scar revision procedure.

If you're troubled by a scar, a good starting point would be to schedule a consultation with a doctor to discuss what can be done.

The procedure

There are several types of scars, which are each treated in a certain way. Here are the most common types of scars, and how you normally treat them:

Keloid:
Keloid is a thick, wrinkly and itchy mass of scar tissue, which grows, elevating the scar. It's often red or darker than the patient's surrounding skin colour. Keloid can appear in all types of scars on the body, although it mostly occurs on the chest, earlobe or shoulder. Keloid growth is more often seen on people of dark complexion than on people with fair skin. The tendency to develop keloid is reduced with age.

Keloid can mostly be treated with an injection directly into the scar tissue in order to reduce redness, itching, and burning sensations. In some cases the scar will contract. If a steroid injection is insufficient the surgeon may cut or freeze the scar tissue off, and then close the wound with stitches. Regardless of how you treat this, kleoid has the unfortunate tendency to return.

Hypertrophic scar formation:
Hypertrophic scar formation is often confused with keloid because both scars have the tendency to become red, thick and raised. Hypertrophic scars usually stay within the area of the original cut, though. The scars often improve on their own, with time, or with the help of an injection. There may be some cases where it will take a year or more before this improvement will show. If this still doesn't appear to be effective, the scar can be treated with surgery - meaning a scar revision. The surgeon will remove the extra tissue, and possibly also reposition the cut to a less visible area.

Contracture:
A burn or injury, resulting in loss of a large skin area, can cause a scar that contracts the edges of the skin together. This is a process which, in medical jargon, is called a contracture. A contracture may affect the nearby muscles and sinews, which can lead to limited mobility. Correction of a contracture involves a surgeon cutting out the scar and removing it, in order to replace it with the use of skin transplantation or a skin flap. A Z-plasty is another method, which in some cases can be beneficial to use. This technique is described further down on this page.

Facial scars:
Due to the localization, a facial scar is often seen as a cosmetic problem, this being regardless of whether it's hypertrophic or not. There are many ways of making a scar less visible. Most commonly the plastic surgeon will settle for a simple carving of the scar, after which it is sewn together using small, fine stitches. This will result in a thinner and less visible scar. However, if a scar is crosswise the patient's natural face lines and furrows, a surgeon will be able to move it so that the scar will become parallel with the facial lines (see z-plastic). This way it will become less noticeable. Dermabrasion, peeling or laser are also valid options. You will be able to read more about this under skin renewal.

Z-plasty:
Z-plasty is a surgical technique used to reposition a scar in order to make it fit more accordingly to the natural lines and furrows of the skin. This way the scar will become less noticeable. A Z-plasty can also help relieve the tightening of the skin that comes with a contracture. With a Z-plasty, the old scar is removed, and new cuts are made on each side, creating small triangular-shaped skin flaps. These are arranged t

Anaesthesia

A keloid treatment is often performed under local anaesthesia, and is ambulant. A surgical scar revision of hypertrophic scar formation can either be done in local or general anaesthesia, depending on the localisation of the scar, and the surgeon's recommendations. Z-plasty is normally performed under local anaesthesia and is ambulant.o form the shape of a Z. Lastly all is sewn together with fine stitching.

Based on a consultation, a surgeon will be able to evaluate whether a Z-plasty or a different form of scar correction is most suitable for the problem present.

Side-effects

Speak to your surgeon about this.

Risk of complications

Scar correction is normally a safe operation.

There is a risk of side effects from the anaesthetic used, along with bleeding, poor wound healing, a poor cosmetic result, and blood accumulation.

No form of surgery is risk free, although severe complications are very rare.

Healing and recovery

Work may usually be resumed after 1-2 days.

Duration of the result

Depends on the technique, character, and extent.