A scar is the natural result of healing from a wound, including a surgical wound. However, the presence of scar tissue can be cosmetically undesirable as well as potentially limit movement or function in the affected area.
Specialists at The University of Kansas Health System are experts at reconstructive wound care. Our team uses advanced techniques to restore the look of a scarred or damaged part of the face or body.
What is scar revision?
Individuals with prominent or troublesome scars may seek scar revision surgery to minimize the scar's appearance. Scar revision:
- Helps improve the aesthetic appearance of scars
- Helps restore elasticity and movement to scarred skin tissue
- Can have a positive emotional impact
Scar revision uses modern surgical techniques to accomplish these goals. The type of procedure chosen will depend on the type of scar. Raised scars are treated by removing tissue, while depressed scars are treated by grafting healthy skin onto the scarred area. Techniques such as tissue expansion and laser skin resurfacing can also be employed in scar revision.
Who can have scar revision?
The presence of visible scarring can have an emotional impact. For this reason, many people have scar revision to restore their appearance and improve the look of the scarred area. This is particularly true in the case of facial scar revision.
Some scarring can also inhibit the physiological function of the scarred area. One example is constrictive scarring, typically from severe burns, which tightens skin tissue and impedes movement in the affected area.
Scar revision treatment typically occurs around 1 year after the scar was created. Candidates for scar revision should not smoke or take nonsteroidal medications, vitamin E or isotretinoin.
How does scar revision work?
Scar revision works by reducing or hiding the visible components of the scar so that it is no longer visible. There are a number of methods for achieving these results depending on the type of scar revision desired.
Excess and discolored scar tissue is removed to treat hypertrophic and keloid scarring. A hypertrophic scar is one that is raised and often discolored. A keloid is a thick cluster of scarred tissue.
Depressed scars, or those that result from an injury where tissue is lost, can be treated by grafting healthy skin from a different area of the body to the scarred area. Depending on the scar, injectable fillers may also be used.
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Benefits and risks of scar revision
Although most scar revision procedures are not major surgeries, all surgical procedures come with some risk of bleeding, infection and complication with administered medications. Other risks include dehiscence (a condition where the wound reopens after the procedure). Additionally, there is a possibility the original scar may reappear.
In cases of severe scarring that causes debilitation, such as with constrictive scarring, the benefit of scar revision is greatly increased quality of life brought about by lessened pain and increased movement.
When scar revision is undertaken to restore the appearance of an injured area, the psychological and emotional benefits of a restored appearance can also lead to a greatly increased quality of life.
What happens during scar revision?
As with most surgical procedures, you will be asked to abstain from food or drink for a certain number of hours before the appointment. The treating physician’s plan will also cover any other special requirements prior to the surgery.
The details of the procedure itself will depend on the type of scar being treated:
A fusiform excision is performed when an elliptical cut is made around the scar and the scar is removed.
A partial or serial excision is used for scars that are too large to be removed in 1 sitting. An ellipse incision is made to remove as much of the scar as possible. At a later date, another ellipse incision can be made to remove additional scar tissue.
If you have a raised scar, a shave excision may be performed in which the elevated portion of the scar is shaved down and the wound is dressed to prevent future recurrence.
A skin graft can be used to repair small, round, depressed scars.
Tissue expansion techniques may be used to stretch the skin near the scar. This aids in the repair of scar tissue.
If you have sufficient tissue around your scar, a Z-shaped or W-shaped incision will be made to break up the scar, change its orientation and make it less noticeable.
Not all scar revisions require an overnight stay for recovery and observation. The site of the scar revision surgery should be kept clean and bandaged during the postsurgery healing and recovery process.