Scar RevisionAbout The Procedure
When the skin is in the process of recovering from an injury, whether the result of an accident, surgery, a burn, or acne, scarring will occur wherever multiple layers of the skin have been affected. Once a scar forms, it is permanent but may be made less visible or relocated surgically. While no scar can be completely removed, plastic surgeons can often improve the appearance of a scar, making it less obvious through the injection or application of certain steroid medications or through surgical procedures known as scar revisions.
Procedure Description
There are a number of Scar Revision options available. Your surgeon will likely recommend one of the following
- Collagen Injections. Collagen Injections are used to raise or fill in sunken scars. Collagen is a natural animal protein, usually produced from purified cow skin. The results of collagen injections are immediate but not permanent. The scars will eventually have to be re-filled as the body slowly absorbs the collagen.
- Dermabrasion. Dermabrasion smoothes out surface irregularities such as deep lines or scars by removing the topmost layers of the skin. The afflicted area will be sprayed with a numbing chemical spray and then carefully “sanded” with a rotating wire brush or a diamond wheel until the desired amount of skin is removed.
- Vascular Laser. Vascular laser works by shrinking the blood vessels that feed the scar. This treatment is done without anesthetic. During the process, the sensation is much like that of a rubber band snapping on the skin.
- Laser Skin Resurfacing. There are two types of lasers used for reducing the uneven surface of scars - the CO2 Laser and the ErbiumYag Laser. The CO2 laser is typically used for deeper scars, while the Erbium is used for superficial scars and deeper skin tones. Both lasers remove the topmost layers of skin, allowing new, smooth skin to form. There are some color lasers that can effectively treat the abnormal red pigmentation of hypertrophic and keloid scars as well.
- Punch Grafting. Deeper scars can be filled in with skin grafted from other places on the body. A tiny instrument is used to punch a hole in the skin, removing the scar. Then a piece of normal skin, usually taken from the back of the earlobe, is put in the scar’s place. The “plugs” are taped in place until they heal. The grafts do form scars of their own but they are less visible then the pitted scars they replace. This procedure is often done in conjunction with dermabrasion or laser skin resurfacing.
- Silicone Gel Sheets. Silicone gel sheets can help flatten hypertrophic and keloid scars. These clear sheets are placed on the scar and wrapped firmly with tape.
- Skin Grafts. In this procedure, doctors take skin from a healthy part of the body and transplant it to the injured area. Grafts aren’t always cosmetically pleasing because the grafted skin may not match the surrounding skin’s color or texture. The area where the graft came from will also scar -- but skin grafts can greatly restore function to a severely scarred area.
- Steroid Applications and Injections. Steroids can help flatten and reduce the redness of hypertrophic and keloid scars. Steroids are applied or injected into the scar to break down the skin’s collagen. This is especially effective on hypertrophic and keloid scars, both of which continue to form collagen after the wound has healed. These injections can also help reduce the itching and/or pain associated with these scars.
- Tissue Expansion. In this procedure, a small balloon is inserted under a patch of healthy skin near a scar. The balloon is filled with a saline solution to stretch the skin. When the skin has been adequately stretched, which can take several weeks or months, the balloon is removed. The scar is then surgically removed, and the balloon-stretched skin is pulled over the previously scarred area and carefully closed.
- Z-Plasty and Related Tissue-Rearrangement Techniques. Z-Plasty is a technique used on hypertrophic and keloid scars that do not respond to steroid treatments. The scar is surgically removed by cutting the skin around the scar in small triangular flaps. These flaps usually follow a Z-shape (hence the name), but the technique your doctor chooses will depend on the shape of the scar. The flaps are repositioned to follow natural lines and creases of the skin. The new scar is thinner and less noticeable. Z-plasty can also help relieve the pressure of contracture scars.
Best Candidates for Scar Revision
Candidates must be in good health, have no active diseases or serious, pre-existing medical conditions, and must have realistic expectations of the outcome of the surgery. Scar removal and revision is best performed after months or years of healing.
Length of the Procedure
Scar Revision surgery typically takes 2 to 3 hours, depending on the extent of the procedure.
Anesthesia
Scar Revision surgery can be performed under local or general anesthesia, depending on the extent of the procedure.
Inpatient or Outpatient?
Scar Revision surgery is typically perfomed on an outpatient basis.
Possible Side Effects
After Scar Revision surgery, some initial swelling and bruising may be experienced around the incision area, but this will quickly subside. New scar tissue should form in a less-pronounced fashion than that of the old scar. Scar revision produces no long-term side effects.
Recovery
Recovery time is largely dependent upon the amount of work required, and also on the position of the scar. It may take as little as 3 days to return to normal activity or as long as 2 weeks. Most people are back to work within a week or two. By the end of a week patients may be able to perform light duties such as using a telephone or computer. Patients should not do any heavy lifting for at least a month.
Duration of Results
Scar Revision surgery results are permanent.
Risks
With Scar Revision surgery, there is the possibility of infection, bleeding, a reaction to the anesthesia, or the recurrence of an unsightly scar.
Cost
Expect to pay $600 to $1,000, depending on the extent of the procedure.
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