What is scar revision surgery?
Scar revision surgery is a procedure aimed at minimizing an existing scar in order for it to blend in and be more consistent with your surrounding skin tone and texture. Scars are an unavoidable result of injury or surgery and their healing can be unpredictable. Scar revision surgery improves and reduces the appearance of scars while also correcting skin disfigurements caused by injury or previous surgery. Although scar revision surgery can provide a more aesthetically pleasing cosmetic result, a scar cannot be completely erased.
Scar tissue forms as the skin heals after an injury or surgery. How much scarring there is depends on a number or variables including size, depth and location of wound, blood supply to the wound, your age, and skin characteristics such as thickness and pigmentation.
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Who is a good candidate?
- Depressed scars
- Contour irregularities
- Hypertrophic scars
- Keloid scars
- Bothered by a scar
- Hyper-pigmented scar
- Overall healthy person
- Reasonable expectations
Types of scar revision procedures
There are several techniques that can be used for your scar revision. Dr. Sufyan uses the latest surgical approaches to improve and reduce the appearance of scars as well as restore function caused by an injury or surgery.
Punch grafts can be used for deep scars without significant color or textural irregularities such as acne scars. This approach involves punching a hole in the skin and removing the scar and replacing it with a new plug of skin.
Scar excision involves cutting out the scar and re-closing the incision. This creates a new scar that appears less visible than the original.
Z-plasty is for long linear scars, contracted, or webbed scars. This procedure involves removing the main portion of the scar and then cutting a series of triangular flaps through the scar in the shape of a “Z”. This is done to relieve a contracted scar by cutting the fibrous tissue and repositions the scar into natural creases.
How is scar revision surgery performed?
Your scar revision surgery can be performed in a hospital, office, or outpatient surgery center setting. Although all surgical incisions create scars, the goal with scar revision surgery is to create a new, less noticeable scar.
Dr. Sufyan will customize an appropriate approach based off of your specific scar presentation and desired goals. The success of your scar revision procedure depends on your complete candidness during your consultation with Dr. Sufyan. Your overall health will be evaluated along with the discussion of your expectations and desired outcomes before making a treatment plan.
Be prepared to discuss why you want the surgery, any medical conditions, drug allergies, medical treatments, and previous surgeries. It is important to discuss this information in order for Dr. Sufyan to gain the best understanding and in turn, create a reasonable treatment plan.
Frequently Asked Questions
What are the risks associated with scar revision surgery?
Although risks are rare, some associated with this procedure are bleeding, delayed healing, change in skin sensation, scar recurrence, dehiscence of the wound, and infection. Following Dr. Sufyan’s postoperative instructions is the key to success of your surgery.
Is anesthesia used for scar revision surgery?
It is Dr. Sufyan’s goal to have you remain comfortable and relaxed for the entire procedure. For most scar revision surgeries, a local anesthesia will be used. It is injected in the skin and surrounding tissues paired with a sedation to keep you comfortable. For larger cases, a general anesthesia can be done.
What should I expect postoperatively?
Although there is usually no excessive pain related to a scar revision, some pain may be present. This is typically controlled with prescription pain medication. Some bruising, scar discoloration, and mild swelling is very normal because your skin has been stressed and cut. It will typically dissipate within the first week.
What is a keloid scar?
Keloids are thick, puckering clusters of scar tissue. They are often discolored and appear darker in color than the surrounding skin. Keloids occur when the body continues to make collagen after a wound has already healed. Unfortunately, keloids have a stubborn tendency to return. To discourage this, Dr. Sufyan can combine scar removal with steroid injections or applying a pressure dressing to the wound site. This lessens the possibility of keloids to recur.
What is a hypertrophic scar?
Hypertrophic scars are similar in appearance to a keloid scar because they are both thick, red, and raised. However, hypertrophic scars remain within the boundaries of the original incision whereas keloids do not. Hypertrophic scars do not get as large as keloids and can fade over time.
What are contractures?
A scar contracture is the result of a contractile wound-healing process that occurs in a scar. They typically appear as fixed, rigid scars that contribute to both cosmetic and functional problems. Contractures can be large, and pull the surrounding skin, causing tightness. Contractures can also negatively affect the underlying muscles and joints, limiting function and movement of the affected area.
Can scar revision fix burn scars?
It is important to understand that surgery cannot remove burn scars entirely, however scar revision can help improve basic functions and make burn scars less noticeable. This involves the modification of the scar tissue after the initial burn wounds/scars have healed.
How long will I be out of work following a scar revision?
Rest and relaxation are strongly advised during the first week post-operative to speed up recovery and minimize bruising and swelling. Patients with sedentary jobs may safely return back to work within days. However, those whose jobs require physical exertion may need an additional week before returning to work depending on their scars location to ensure proper healing.
In every case, it is recommended to avoid unnecessary exertion for at least one month after surgery to maximize recovery and proper healing of your scar. It is important that the surgical incisions are not subjected to excessive force, abrasion, or motion while healing.
How might scar revision affect my everyday life?
A flawed scar can unfortunately serve as a constant reminder of the traumatic experience that caused it. The new and improved appearance of your scar can bring increased satisfaction to both your appearance and self-esteem! It can also restore or improve function when a scar interferes with the movement of muscles or joints.
Does insurance cover scar revision surgery?
Although most health insurance plans do not cover cosmetic procedures, if scar revision is being performed to minimize scarring from an injury or to improve your ability to function, it may be covered. It is advised to check your policy or call your insurance carrier to determine which scars and treatments are covered.
Does scar revision surgery require an overnight hospital stay?
Scar revision surgery can be performed in an outpatient surgical center or a hospital. You will most likely be able to go home following your procedure.
Are there any medications that need to be avoided before surgery?
It is important to avoid taking certain medications, vitamins and herbs two week prior to your surgery. This is because some medications may cause you to bleed more than normal.
How long should I avoid exposure to sunlight?
Avoid having the sun on your wound/incision as much as possible. If your scar is in a place that is difficult to cover, be sure to use a good sunscreen or shade it with a hat. Sun exposure to a fresh scar will cause discoloration and result in a more prominent scar. Dr. Sufyan will tell you when it is safe to apply makeup or ointments, but typically when sutures are removed and the incision has completely closed it is safe to do so.
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