SCAR REVISION

Scars on the face are very emotionally disturbing to the person who has them, especially if the scars are wide, elevated, depressed, or appear long, discolored or distort adjacent facial features. The appearance of unsightly or disfiguring scars of blemishes may be improved by well-planned and carefully executed surgery. However, there are very important facts that patients should consider if they are contemplating this type of procedure.

Facts to Consider

The goal of surgical treatment of scars is to make a new scar which will be less noticeable than the present scar: an exchange of a bad scar for a better scar. Scars which possess some of the traits listed above can be improved, as the surgeon tries to diminish as many of the undesirable traits through surgery. Each incision is made into the skin, regardless of where it is placed or who made it, heals in the same manner as any other cut based on the patient’s own healing capacity.

Understanding the Procedure

New scar tissues are produced by the incision which is made to correct an unsightly scar. The surgeon tries to develop a new scar which has a fine line: one which will become more level and blend in to the surrounding area. The surgeon also tries to develop a scar which causes no contractual pull on the surrounding structures. Every effort is made to blend the surgical scar in, or parallel to, one of the normal crease lines of the face and body. It may take two surgeries or a combination of surgery and skin grafting to obtain the best result for the patient. A final step may be the use of dermabrasion (see related section). The surgeon is able to determine the best method of treatment for a patient.

There is minimal discomfort with this type of surgery, and in most cases, patients can return to work, school, and other activities the next day. To camouflage the area, it is not unusual to place flesh-colored tape over the surgery site.

The Healing Process

Patients may anticipate that surgery will produce immediate results; however, that is not the case. A maturation process will occur that will continue to change the appearance of the previously scarred area. Once healing is complete, the scars will be mature, and they will undergo no further change in appearance. This process takes place over a period of six to eighteen months, sometimes longer.

Immediately following surgery, a fresh scar may look good, although it may be raised slightly above the skin’s surface. In the next two to three weeks, the area becomes reddened and somewhat lumpy in comparison to the surrounding skin, and may have a hard consistency. This is a natural part of the healing process: the tissue needs to develop a base on which to heal. Later, over the next several weeks and/or months, the scar will soften, flatten, and become paler than the adjacent skin.

When Surgery is Appropriate

Scarring that is a result of an accident will take the same time to heal as any other type of scarring. It is necessary that the scar be on its way to maturity and become soft before the decision to undergo surgical treatment is made. Sometimes, the natural healing process produces results that do not require surgery. But if surgery is required, it will not be as complicated as it would be if the scarred area were treated immediately after the surgery.

However, there are scars which require revision surgery before the scar is mature and soft. Scars which result in distortion of normal structures, such as the eyebrow, eyelid, lips or nostrils, may require immediate attention. Those that have an obvious wideness or depression as well as U-, C-, or V-shaped configurations will require plastic surgery to correct the underlying tissues and provide a good base for the scar to begin to heal. Otherwise, the scar areas may contract and distort other structures.

A variety of techniques are used to revise unsightly scars and to make them less noticeable. These techniques may be used over a period of time to produce a favorable result. Techniques include scar revision or camouflage techniques, laser-abrasion, dermabrasion, and others. The important fact to remember is there will always be a scar, but it will be less noticeable.