Scar Revision

SCAR REVISION:

Scar revision is a specialized field within plastic surgery focused on improving the appearance of scars. Whether resulting from surgery, trauma, burns, or other injuries, scars can significantly impact a person's self-esteem and quality of life.

TYPES OF SCARS:

  • Hypertrophic Scars: Raised, red scars that stay within the boundaries of the original wound.
  • Keloid Scars: Similar to hypertrophic scars but extend beyond the original wound boundaries. They can continue to grow and are often more challenging to treat.
  • Contractures: Result from burns, causing tightening of the skin that can restrict movement.
  • Atrophic Scars: Depressed or sunken scars, often resulting from acne or chickenpox.

FACTORS AFFECTING SCAR FORMATION:

  • Genetics: Individual healing responses and propensity for abnormal scarring.
  • Wound Location and Tension: Areas with high tension or movement tend to scar more.
  • Infection and Wound Care: Proper initial wound care can minimize scarring.
  • Age: Younger skin tends to scar more easily due to higher collagen production.

WHAT CAN A SCAR REVISION DO FOR ME?

  • Improve the cosmetic appearance of a scar.
  • Restore function if the scar impairs movement or causes discomfort.
  • Improve pain and itching in scar.
  • Enhance self-confidence and psychological well-being.

HOW WILL MY SCAR BE REVISED?

Non surgical methods:

  • Topical Treatments:
  • Silicone Sheets and Gels: Reduce scar thickness and improve texture.
  • Corticosteroid Creams: Help reduce inflammation and flatten hypertrophic and keloid scars.
  • Emollients: Help keep scar hydrated and improve appearance.
  • Intralesional Injections:
  • Steroid Injections: Effective for reducing hypertrophic and keloid scars by decreasing collagen synthesis.
  • 5-Fluorouracil (5-FU): Often combined with steroids to improve results.
  • Botulinum Toxin (Botox): Reduces tension around the scar, potentially improving healing.
  • Laser Therapy:
  • Fractional CO2 Lasers: Improve texture and reduce pigmentation.
  • Pulsed Dye Lasers (PDL): Target blood vessels in red scars, reducing redness and size.
  • Microneedling:
  • Involves creating micro-injuries in the skin to stimulate collagen production and improve the texture and appearance of atrophic scars.

SURGICAL METHODS:

  • Simple Excision: Removing the scar and closing the wound with fine stitches to create a less noticeable scar.
  • Z-Plasty and W-Plasty: Techniques that change the direction of the scar to align with natural skin folds, reducing tension and improving appearance.
  • Tissue Expansion: Involves inserting an expander under the skin near the scar. Over time, the expander is gradually filled with saline, stretching the skin. The scar is then excised, and the expanded skin is used to cover the area.
  • Skin Grafts and Flaps:
  • Skin Grafts: Involves taking skin from one area of the body and moving to the scarred area. Common for large scars and burns.
  • Local Flaps: Using adjacent tissue to cover the scar, maintaining blood supply for better healing.

COMBINATION TREATMENTS:

  • Oftentimes, a combination of treatments is used, for example,
  • Laser therapy followed by microneedling.
  • Excision combined with steroid injections to prevent recurrence of keloids.
  • Surgical revision followed by laser treatment for improved texture.

INNOVATIONS IN SCAR REVISION:

  • Stem Cell Therapy: Research is ongoing into using stem cells to promote healing and reduce scarring.
  • PRP (Platelet-Rich Plasma): Utilizing the patient’s own blood to enhance healing and improve scar appearance.
  • Bioengineered Skin Substitutes: Advanced materials designed to mimic natural skin and promote better integration and healing.

HOW DO I TAKE CARE OF SCAR AFTER SURGERY?

Post-procedure care is critical for optimal results and minimizing complications:

  • Keeping the area clean and protected.
  • Using sunscreen to prevent pigmentation changes.
  • Removing sutures on exact time advised by your surgeon.
  • Monitoring healing and addressing any concerns promptly.

ARE THERE ANY RISKS AND COMPLICATIONS?

While scar revision generally has high success rates, potential risks include:

  • Infection
  • Bleeding
  • Recurrence of the original scar
  • Changes in skin sensation
  • Adverse reactions to anesthesia
  • Unsatisfactory results

CAN SCAR REVISION COMPLETELY REMOVE MY SCAR?

While scar revision can significantly improve the appearance of a scar, it cannot completely remove it. The goal is to make the scar less noticeable by blending it with the surrounding skin and improving its texture and color.

BOOK A CONSULTATION WITH DR. HIRRA ALAVI FOR SCAR REVISION:

During consultation, Dr. Hirra Alavi will ask about previous surgeries, scar history, and any factors that might affect healing (e.g., smoking, diabetes). You will have the chance to express your goals, expectations, and concerns with her. You will be asked about any existing medical conditions, medications and allergies to evaluate your overall health. She will evaluate the type, size, location, and characteristics of the scar and give a customised plan for you. During the consultation, ensure that you feel comfortable and confident with her approach and communication style. A good surgeon will listen to your concerns, answer your questions, and provide honest advice about what can be realistically achieved. Detailed information about scar revision including pre and post operative instructions, risks, possible complications and prescription will be provided to you.

Reach out to our clinic to schedule your consultation today. We're eager to assist you!