Facial Scar Revision

Facial scars are often unavoidable when caused by injury, trauma or surgery. Although a facial scar is harmless, it can cause some people to feel self-conscious about how they look.

Fortunately, there are a variety of options for improving the look of facial scars so that they are hidden or barely visible. Some scars respond to topical gels, steroid injections, laser treatments or dermabrasion. In other cases, surgical scar revision is the best option.

At The University of Kansas Health System, our specialists carefully consider the size and shape of your scar, as well as your skin tone, prior to making a customized scar revision treatment plan.

When the body’s natural healing process attempts to repair damaged skin, the fibrous tissue that develops to mend the area structurally differs from healthy skin – resulting in scar formation. Facial scar revision is a procedure to diminish the appearance of scarring and skin trauma as much as possible for an improved aesthetic result.

Scars can be subtle, distinct or highly conspicuous. Many scars are characterized by an uneven tone or texture, abnormal pigmentation, skin depression or elevation and/or impaired function of the sweat glands or hair follicles. For men and women seeking to minimize the visibility of scars, a number of surgical techniques can be used to blend the damaged areas with healthy skin for less prominent scarring.

Anyone who is bothered by the appearance of a facial scar may benefit from facial scar revision surgery. Depending on the size, type, depth and extent of scarring you wish to address, scar revision can generally achieve the following:

• Enhance the look of skin changes or disfigurement
• Improve or reduce the appearance of obvious scarring
• Reduce irritation, itching, pain or inflammation
• Treat hypertrophic scars, keloid scars or contracture scars

The nature of your scar revision treatment will depend on the type of scar you have. In general, the most commonly treated scars include:

Hypertrophic and keloid scars tend to arise more commonly in people with darker skin types, but are seen in all skin complexions. These scars can be difficult to treat, but are frequently improved with a combination of medical and surgical therapy. Steroid injections are often used to soften the scars prior to any surgical intervention.

The benefits of facial scar revision include less noticeable facial scarring and restored appearance. In cases where scarring is impacting facial expression movement, scar revision surgery can improve function and flexibility of the skin.

Like any surgical procedure, there are risks associated with facial scar revision. Your surgeon will thoroughly explain the benefits and risks during your consultation.

When surgical revision is recommended, several approaches are often combined to provide the best result. These surgical techniques may include:

• Scar excision
• W-plasty
• Z-plasty

W-plasty and Z-plasty are methods of tissue rearrangement that are used to break up and camouflage a scar. This concealment is accomplished by repositioning the scar so that it follows the natural creases and marks of the skin, thereby making the defect less noticeable.

Both W-plasty and Z-plasty may also be used to relieve pressure caused by contracture – a restrictive tightening of the skin’s edges commonly experienced during the healing process in burn wounds. Contracture typically limits mobility in the affected area, and the tissue flaps created by Z-plasty have been shown to effectively increase flexibility where movement may be strained.

Other options to reduce scarring may include tissue expansion or skin grafting.