Scar Revision

Scars can be explained as the marks of injury or surgery. Whenever the continuity of the skin is broken, the healing occurs by formation of scar.

There are many factors which decide how a scar would look like. Some of them are :

  • Healing property of the person:- Some people have a tendency to form keloids and hypertrophic scars.
  • Severity of the injury :- A wound that is deep and big will form bad scar compared to those with minimal trauma.
  • Site of scar :- A scar that falls in the line of skin creases will be less visible.
  • Color of skin :- People with dark skin form scars which are more visible. The tendency to develop keloid and hypertrophic scar also increases in them.

It should be noted that a scar can not be completely removed even  by plastic surgery. A plastic surgeon tries to make the scar less noticeable with the help of various techniques.  One of them is the procedure of scar revision, an operation for making the scar less visible.

Most scars settle over a period of one year, that is they become less visible, less hard and symptoms like itching and redness decrease. Hence plastic surgeons advise to wait for about a year after injury or operation before going for scar revision surgery.

There are several types of scar and several methods to correct them.

  • A scar that is moderately wide and with prominent stitch marks can be excised and the new wound edges can be brought together by fine sutures to give fine line like scar.
  • A scar that is placed across the direction of skin creases and folds, can be made less visible by a procedure known as Z – Plasty. Here the surgeon changes the direction of the  scar by making a Z, raising the flaps of tissue and reorienting the Z in such a way that the new scar falls, for the most part of it, in a natural skin crease.
  • Hypertrophic scar is the one that is raised above the surface. Though it looks like keloid it is different from the keloid as it does not extend beyond the boundaries of the scar. Such scar can be handled by giving steroid injections in to the scar. The steroid injections selected are of locally acting type. These steroid are safe as they remain confined to the scar only and does not produce commonly seen side effects of the steroid.
  • Keloids are an extension of scarring process. In simple words it can be said that they occur because the body continuous to produce scar tissue fibers known as collagen, even after the wound has healed. A keloid extends beyond the boundary of the wound, is red and itchy.  Keloid can occur in any area of body but most common sites are, chest wall, earlobe and shoulder. It is more likely to occur in dark skinned people. Some people have a tendency to develop keloid, that is they form keloid very easily when they are injured or undergo operation. Keloids can be treated by injecting steroid injection in them, giving pressure by specific pressure appliances or by surgery. When treated by surgery, the chances of recurrence or formation of new keloid from the area where skin is taken for replacement, are very high, especially in persons having tendency to form keloid.