I often get asked questions about scar revision
or procedures that can be done to make the appearance
of a scar better. Patients will come asking if the scars can be revised to improve
their appearance or even if scars can be removed completely
the answer is that scars cannot usually be removed
completely as much as I'd like to be able to say that plastic surgeons can do that
for the most part we really can't. What we can do though is to revise the scars,
make them thinner in appearance, sometimes reorient them, or place them in a position
that's less conspicuous
So that all falls under the general topic or category of scar revision
I'd say that for most patients with scar revision the
common requests really come down to areas where they've had a scar from
either prior operation where things may not have healed as was they'd like
either the general area where it was closed or just under a lot
of tension
and so the scar has just widened, or staples or sutures were used and
were left in a little bit longer than
they could have been. They may have healed with some marks
or in cases where there was even a past infection again from surgery
or from an injury like a laceration from an accident
all those are circumstances where scars may heal
in a less than ideal manner that could be made better with a scar revision.
Most patients that come to me for scar revision they vary widely in age
but in most cases there's a specific area where the scar is
really widened or really just doesn't have an ideal appearance
really it can vary from the trunk, abdomen, breast, sometimes there's scars people
have on their arms or legs
It really varies widely. I would say the best
candidates for it are patients who have at least waited a year after the previous scar
has
completely matured. Now what happens is that
when a previous injury has been
repaired and healed or previous surgery has been done,
scars really take about a full year to mature
and what that means is a initially they can thicken,
they can be a little bit dark, but over time they can really faid quite a bit
and it really takes the body about a full year to really do this
to its maximum potential. I typically like to wait this full year
because my personal opinion is that I think the body can actually do in that first
year
better things that what we can accomplish surgically and it's therefore worth it
to wait that full year to see what the body can accomplish on its own
If after that first year
it really hasn't healed as nice as we like then at that point we can try surgery and
see if that will make things better
The procedure is usually about
an hour long. This can vary quite a bit depending on the length
of the scar or where it's located
this can almost always be done under local anesthesia. My method of doing a scar
revision
is not just to excise the scar and then to close it, but
after excision I typically will raise the skin
andfat on both sides, move things toward the center, and then close it under minimal
tension
it's my belief that bascially by having less tension
during which the scar is healing, there is less chance for that scar to be pulled apart
or widened
during its healing process, so I typically like to advance
the skin on both sides to that minimize tension
I think that leads to very nice results and I've had good success with that
After the procedure
I will usually put dressings on the area depending on the patient
and on the nature this scar I will sometime tape it with a variety of surgical
tapes
I do tend to see my patients after scar revision pretty frequently
usually about a week, two weeks,and then one, two, and three month periods
and this is good because it allows me to tailor
what I tell a patient do post operatively to really give them the best result in
the end I think that's sort of combining careful surgical technique,
careful evaluation, timing, as well as good post operative care
you can get really nice results. In some cases the scar can really be
thinned out quite a bit and patients are usually quite happy