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before and after

Scar Revision

Unsightly facial/body scars, blemishes and moles can very often be improved by well planned and carefully executed surgery.

It must be stressed again that a cosmetic surgeon cannot make invisible scars. He can only make the scars as inconspicuous as possible. The aim of scar revision is to achieve a scar which is fine, level and even with the surrounding tissue, about the same colour as the adjacent skin and which causes no pull on the surrounding structures.

The old unsightly scar has to be removed first. Any planned surgical incision heals in exactly the same manner as any other deliberate or accidental cut, i.e. it produces scar tissue which is nature’s method of healing. Once an incision is made and sutured the surgeon has little control over the healing process, a fact which must be appreciated by the patient.

It is often not realized that a period of 6 to 18 months must elapse before the scar is mature, which is the stage where no further change or improvement will occur.

Initially any scar will be red and raised above the level of the surrounding skin and may often be hard in consistency. Gradually the redness and hardness lessen and resolve leaving a soft scar, which is level with and somewhat paler than the adjacent skin.

For these reasons scar revision must not be undertaken too soon because adequate time must elapse to allow the healing tissues to mature.

When revising a scar on the face the surgeon attempts to get the best possible result by placing the new scars parallel to or actually in one of the normal crease lines of the face. This usually means that the direction and shape of the original scar has to be changed. Scars on the face, such as those caused by acne or chicken pox or small lacerations, can often be dramatically improved with dermabrasion.

Excision of large scars or blemishes may require several operations over a period of time. It must also be mentioned that some areas of the body always produce noticeable scars e.g. nose, chin, chest, shoulders, upper back and parts of the arms and legs.

In summary therefore, the goal in scar revision is improvement and not perfection. Patients who are unable to accept this should not have treatment.