Scar Revision
What is a scar ?
A scar is one of the bodies responses to injury. Scars undergo various phases of maturation. Following injury or an operation, a typical scar develops as quite red for 3-6 months before settling as a light coloured flat scar.
Why might my scar look bad?
A scar may look bad because it is still going through a remodelling phase of maturation. This is a normal process. During this phase the scar is slightly raised and usually darker than the rest of the skin. This is normal and may take up to 6 months to settle down.
When is scarring abnormal?
If a delicate balance is not achieved during the healing process after injury or operation, a scar may display abnormalities resulting in more noticeable scars that can be itchy and painful as well as unsightly.
There are 3 types of abnormal scars:
Keloid – usually red and raised and extends onto uninjured skin that surrounds the original site of operation or injury. Develops due to an overgrowth of tissue. If a keloid scar is removed, it will often recur.
Hypertrophic – usually raised, red and painless.
Contracture – These scars tighten skin, which can impair your ability to move. Can occur if your skin has been burnt.
Abnormal scars occur because of genetic factors and injury or surgical factors or a combination of both.
How are abnormal scars treated?
Abnormal scar appearances can be improved with both nonsurgical treatments and/or surgery. In difficult cases a combination of techniques are utilised.
What are the non-surgical ways to treat scars ?
In addition to scar massages, silicon and laster therapy, in some cases, cortisone injections can improve the scar appearance by reducing scar thickness, redness and/or itching. Otherwise surgery will be required.
What does surgery involved for scar treatment / scar revision?
The surgical technique and timing selected depends on the type, size and site of the scar.
Surgical options include:
Completely removing the scar and then mending the wound again
Taking skin from other areas to cover up the areas of the scar (also known as skin “flaps” or “grafts”)
Making the scar less noticeable by changing the direction of the scar (the z-plasty technique
Meticulous technique, both in removal of the existing scar and also the repair (suturing) of the wound is paramount. The post-operative care of the wound and removal of sutures is also very important. Non-surgical techniques after surgery are also utilised.