What is a Scar Revision?
Scar revision is plastic surgery performed to improve the condition or appearance of a scar anywhere on your body. The different types of scars include:
Discoloration or surface irregularities and other more subtle scars can be cosmetically improved by surgery or other treatments recommended by your plastic surgeon. These types of scars do not impair function or cause physical discomfort and include acne scars as well as scars resulting from minor injury and prior surgical incisions.
Hypertropic scars are thick clusters of scar tissue that develop directly at a wound site. They are often raised, red and/or uncomfortable and may become wider over time. They can be hyperpigmented (darker in color) or hypopigmented (lighter in color).
Keloids are larger than hypertropic scars. They can be painful or itchy, and may also pucker. They extend beyond the edges of an original wound or incision. Keloids can occur anywhere on your body, but they develop more commonly where there is little underlying fatty tissue, such as on the face, neck, ears, chest or shoulders.
Contractures are scars that restrict movement due to skin and underlying tissue that pull together during healing. They can occur when there is a large amount of tissue loss, such as after a burn. Contractures also can form where a wound crosses a joint, restricting movement of the fingers, elbows, knees or neck.
The type of scar you have will determine the appropriate techniques your plastic surgeon will use to improve your scar.
What are Scar Revision surgery?
Scar revision is surgery to improve or reduce the appearance of scars. It also restores function, and corrects skin changes (disfigurement) caused by an injury, wound, poor healing, or previous surgery.
Scar tissue forms as skin heals after an injury (such as an accident) or surgery.
- Size, depth, and location of the wound.
- Your age.
- Skin characteristics, such as color (pigmentation) Depending on the extent of the surgery, scar revision can be done while you are awake (local anesthesia), sleeping (sedated), or deep asleep and pain-free (general anesthesia).
When to have scar revision done is not always clear. Scars shrink and become less noticeable as they age. You may be able to wait to have surgery until the scar lightens in color. This can be several months or even a year after the wound has healed. For some scars, it is best to have revision surgery 60 to 90 days after the scar matures. Each scar is different.
There are several ways to improve the appearance of scars:
- The scar may be removed completely and the new wound closed very carefully.
- Dermabrasion involves removing the upper layers of the skin with a special wire brush called a burr or fraise. New skin grows over this area.
- Dermabrasion can be used to soften the surface of the skin or reduce irregularities.
- A laser may be used to soften the surface of the scar, and stimulate new collagen growth within the scar.
- Very large injuries (such as burns) can cause loss of a large area of skin and may form hypertrophic scars. These types of scars can restrict movement of muscles, joints and tendons (contracture). Surgery removes extra scar tissue. It may involve a series of small cuts (incisions) on both sides of the scar site, which create V-shaped skin flaps (Z-plasty). The result is a thin, less noticeable scar, because a Z-plasty may re-orient the scar so that it more closely follows the natural skin folds and releases tightness in the scar.
- Skin grafting involves taking a thin layer of skin from another part of the body and placing it over the injured area. Skin flap surgery involves moving an entire, full thickness of skin, fat, nerves, blood vessels, and muscle from a healthy part of the body to the injured site. These techniques are used when a large amount of skin has been lost in the original injury, when a thin scar will not heal, and when the main concern is improved function rather than improved appearance.
- Tissue expansion is used for breast reconstruction. It is also used for skin that has been damaged due to birth defects and injuries. A silicone balloon is inserted beneath the skin and gradually filled with salt water. This stretches the skin, which grows over time.