Scars, whether they’re caused by accidents or by surgery, are unpredictable. A good scar is typically a scar that is flat, thin and has a close skin tone match to your surrounding skin. A bad scar is a scar that is raised, wide or thickened and much darker or lighter than the surrounding skin. How much the appearance of your scar bothers you is a personal matter. It typically takes one year for scars to fully mature. Initially scars can be red or brown which fades over time. During this time the collagen remodels and the color changes. Scar revision surgery may be an option for some who have a bad scar that is raised, widened, painful or that is contracted or tethered to the area below.
If you’re considering scar revision, this will give you a basic understanding of the most common types of scars and the procedures used to treat them.
What is scar revision surgery?
Scar revision surgery can be performed in multiple ways. The surgery consists of basically cutting out the old scar and sewing the scar back together in a more controlled fashion. Occasionally scars that are caused by trauma, that have had an infection in the wound or are located in an area of motion, can spread over time. These scars become raised or thickened and can be very unappealing. Occasionally scars have to be redirected in their orientation or a Z-Plasty where the scar is taken from a straight line or made into a zig-zag line to allow for motion of the scar or to increase length in the scar in an area that may be tethered.
Are there other options?
Sometimes laser treatments including CO2 resurfacing and fractionated laser skin resurfacing can improve the contour of the scar and the remodeling of the scar. Laser therapy works by drilling very tiny micro columns or holes into the skin. This allows the body to produce new collagen in those areas. This can make the scar smaller, flatter, more pliable and more cosmetically appealing. Occasionally when a scar is dark or red in color, laser treatments can reduce the pigment or vessels that cause the redness in the scar to improve the appearance of the scar and make it less perceivable. When we evaluate scars for to see if laser or additional surgery is necessary, the quality, contour and the age of the scars all come into play. Occasionally patients think their scar is an unattractive scar that’s actually not a bad scar. Again, when Dr. Moenster looks at the qualities of the scar to see if it is flat, thin, a good skin tone match and non-painful. If it doesn’t meet this criteria it is usually indicated as a scar that should have laser treatments or be surgically removed.
Occasionally we need to do multiple procedures or treatments for these scars. Thickened, keloid or hypertrophic scars can also be treated with pressure dressings, silicone sheeting, silicone dressings, injections of intercessional Kenelog or steroids to calm the scar down, flatten it and reduce redness and thickness.
Evaluation of your scar can be a good chance to collect additional information as well as education on your scar and to then use this information to determine which procedure is best for your scar that you have concern over.
Scar revision surgery depends a lot on your individual circumstances. If you have more questions about this procedure please be sure to ask your doctor if there is anything about the procedure you don’t understand. Dr. Jamie Moenster and her Tucson and Sierra Vista staff are here to answer your questions and to help.