Scar revision is a reconstructive surgery aiming at reducing a scar and unifying its surface and texture to meld with the surrounding skin.
A scar is an obvious skin mark that remains after a wound has healed. The scar in itself is inevitable, however its severity depends on the size of the wound, its depth and position and also on the person’s age, genetics and skin type. Poor skin healing after a surgery or injury may sometimes lead to disfiguring scars, which will have a psychological impact especially if it’s on the face. Scar repair is the ideal answer to reduce the physical and emotional impact of scars.
What are the options for scar revision?
Depending on the severity and type of the scar, the options for scar revision include:
1- Topical Revision: Topical revision is usually used to treat fade scars and consists of using gels, creams and external compression.
2- Non-invasive Revision: This type of revision includes several techniques and is usually used to treat surface skin irregularities like acne scars:
- Chemical peeling: It consists of removing the upper skin surface using glycolic or lactic acid, which helps soften skin irregularities and stimulate the growth of new tissue.
- Laser: Laser resurfacing is the removal of the upper skin surface using a beam of light to allow healthy skin to grow in the treated area.
- Dermabrasion: It is the “polishing” of the upper skin surface using a quickly rotating wire brush to allow new healthy skin to grow in the treated area. This procedure usually takes one hour.
3- Surgical Revision: Surgery revision is usually used to treat disfiguring scars, abnormally located and developed, which are the result of injuries such as burns and big surgery incisions. These types of scars may lead to excess growth of scar tissue. They can also obstruct joint motion, cause itching and pain and prevent the person from leading a normal lifestyle.
Am I a good candidate?
Determining if you should consider a scar revision surgery depends on the severity of your scar. Scar repair can be performed on people of all ages and is the ideal solution for patients who are emotionally affected by a disfiguring scar and who still bear the traumatizing impact of the accident that caused it. Good candidates are people who are non-smokers and in good physical health, with no pre-existing health conditions. They should also have realistic expectations that the scar won’t totally disappear but will fade greatly and blend with the rest of the skin.
How is it done?
The scar revision surgery involves several techniques, depending on the size and depth of the scar:
1- Z Plasty Revision:
During this procedure, I will remove the scar tissue and then make new incisions on both sides of the scar, in a zigzag pattern, to create small triangular skin flaps. These triangles are repositioned to cover the affected area and then the incisions closed with thin stitches. This procedure is mostly common in patients who suffer from impaired movements due to a contracture scar. It allows them to restore a more natural skin appearance and normal movement.
2- Skin Graft Revision:
This procedure is usually done under general anesthesia. A section of healthy skin is removed from a different body part (like the inner thighs). Once done, this graft is transplanted to cover the scarred area. This technique will allow the new skin to feed on the vessels and scar tissue that will form in the injured area, and grow into the recipient area.
This procedure involves different stages. A tissue expander, which is a special balloon, is placed under the skin in the surrounding area of the scar. Over several weeks, this balloon is filled with water to stretch the skin and obtain extra tissue. The last stage is to extend the new skin to cover the scarred area.
How long is the recovery?
It is normal for the patient to experience swelling and discomfort in the first couple of weeks following the surgery. The new skin will tend to have a different color than its surrounding. It will take several weeks for the scars to heal and fade. Final results will only show after six to twelve months. Patients can resume their normal lifestyle within few days but should refrain from strenuous activities for few weeks. You will be given specific instructions on how to care for your surgical site and what medications to take in order to relieve the pain and reduce the risk of infection. Be sure to ask all the questions concerning what to expect during the recovery period.
Disclaimer: The info presented on this page is indicative and for generic use only. Each patient’s case is unique and will be studied by Dr. Chadi Murr for full assessment.