WHAT IS SCAR REVISION?
Scar revision is the name given to a group of surgical techniques used to alter the appearance of scar tissue, blending it with the surrounding skin area. Whilst scar revision cannot completely remove evidence of a scar, it can be used to remove keloid scars, hypertrophic scars, contractures, and facial scars, regardless of whether the scars were caused by injury or previous operations.
The Scar revision technique can be used on scar tissue anywhere over the body, but people typically elect to have this surgery where scar tissue is highly visible, such as on the face, hands, or forearms. Scarring is often unavoidable when skin is cut or damaged through its full thickness. Some people naturally make better scars than others. We cannot accurately predict this, but in general, we are aware that patients with black skin and, at the opposite end of the spectrum, patients with fair freckled skin and red hair will tend to produce poor scars.
Scar revision generally produces permanent results and may take anywhere from 1 – 3 hours to complete, but is very dependent upon the amount of work required. The patient will normally be under a general anaesthetic and overnight hospital stays are rare.
WHAT TYPES OF SCARS ARE TREATED?
Keloid scar removal – Thick, puckered, and itchy dark red scar tissues that grow beyond the boundaries of an incision during the healing process associated with a previous operation can be removed by scar revision. A surgeon cuts out the material, normally made of hard fibrous collagen, and then the skin is sewn back together. After the procedure, it is very important to monitor the scar for signs of keloid recurrence as preventative measures can be instituted.
Hypertrophic scar removal – Often confused with keloid scars, hypertrophic scars are thick red and protrusive. But, unlike keloid scars that grow outside the initial incision area, hypertrophic scars remain within the original incision boundary. A surgeon will remove this excess scar tissue, and may re-position the original incision line, so it heals in a less-visible fashion.
Contractures – Loss of substantial skin areas through burns or other injuries results in scar tissue pulling together outlying skin areas, sometimes restricting muscle movement. Scar revision can help release that ‘ pull’ by replacing the scar tissue with a skin graft.
Facial scars – Although facial scars cannot be completely removed, it is possible for a surgeon to re-position a scar to match natural facial contours and lines, making the scar less visible. To do this a surgeon will use a scar revision technique known as z-plasty. This involves the surgeon removing the scar tissue and then cutting the skin to create triangular flaps at both ends. The flaps of skin are then laid across the original scar area at angles, often creating a ‘ z’ shape. The flaps are then sewn over the area, reducing the visual impact of the original scar.
AFTERCARE AND 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.