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Scar Revision

Scar Revision Surgery - Sarasota, FL

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Overview

A scar is the sign that a wound once existed. Scars can be unsightly or almost completely invisible. Scar revision treatment is a procedure offered by our Sarasota plastic surgeons, that is designed to improve the appearance of an unsightly scar, or the function of the area of skin surrounding the scar. Although scars cannot be completely removed, our skilled cosmetic surgeons are able to improve the overall visibility by reducing the size, lightening the color, or making it appear flatter. Scar revision treatment is most often performed on scars that develop to keloid, hypertrophic or contracture scars. A full analysis will be given during the consultation and a treatment plan provided to minimize the scar's appearance.

Types of Scars

Scar revision surgery and the approach taken will depend on the type of scar that is being addressed. It helps to understand the various types of scars:

 

  • Superficial scars settle only on the top skin layer. It is the least noticeable of all types of scars.
  • Keloid scars form tissues that grow beyond the wound’s edge. They can be dark, painful and lumpy.
  • Hypertrophic scars look like keloids, however, the tissue growth is limited within the wound area.
  • Contracture scars cover a large section of skin. A good example is severe burns. The newly formed tissues tighten the skin around the wound and may cause issues with mobility.

Surgical Technique

There are various techniques to consider during a revision surgery. Scar revision treatment will be chosen based on the scar’s location, type, size and overall extent and may include one of the following approaches. 

Shave Excision

Shave excision is performed when the scar tissue is raised. A surgical shaver is used to slowly trim away the scar and flatten out the surface. Local anesthetics may be used. The ‘shaved’ area will be treated with topical medications. This technique is simple and in most cases, sutures are not needed to close any wound.

Scar Removal/Modification

Another technique that improves a raised scar is by completely removing it or reopening then reclosing the wound. By removal, incision is made in an ellipsis pattern with a small border of good skin and closing the wound with sutures within or outside of the skin. By modification, the scar is reopened by means of incision, but this time along a different direction to minimize visibility, and then the wound is resutured back. This is the ideal approach for scars that developed due to poorly closed sutures.

Skin Grafting/Tissue Expansion

There are cases in which the removal of large scars requires repair by fillers. In such circumstance, a skin graft with skin harvested from another part of the body is a popular method to make sure that the skin blends well during the healing process. Sometimes, tissue expansion is applied instead of the skin graft. In this process, a tissue expander is placed within the reopened scar. This expander is filled with a sterile solution. Sutures will be used to join the tissue walls together and to close the wound.

Injectable Treatments

In some cases, scars are depressed instead of raised. This type of scar is best treated with a derma filler that is injected into the scar site. A common material for this is known as a derma filler, and there are many variants that are available as alternatives. In many cases where scar treatment is concerned, these fillers are collagen based. Once injected, the filler will puff the scar area so that it evens out with the normal skin’s surface. This is done while the doctor reshapes the skin outside to make sure the surface flattens out.

Surface Treatments

Surface treatments such as laser treatments, chemical peels, dermabrasion and skin bleaching may be considered for mild scars. The aim of these applications is to discard the top skin gradually and consequently, flatten out the surface, and possibly change the color of the skin tone. Skin lightening techniques are also applied when the skin on the scar area is darker than the natural skin tone.

During/After Surgery

Scar treatment is usually performed using a local anesthesia. In cases where a large area is going to be treated, a general anesthesia may be needed. Post-surgery care is critical when it comes to scar treatments. Patients must adhere to the medications and proper wound care to promote better healing of the new wound resulting in a less visible scar. Although a scar will still exist on the site, patients note a significant improvement. It usually takes between 6 months and longer for optimal results.

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The board-certified plastic surgeons of Sarasota Plastic Surgery Center, Dr. Braun Graham*, Dr. David Mobley*, Dr. Scott Engel*, and Dr. Brian Derby, offer a comprehensive range of cosmetic plastic surgery procedures. All information subject to change. Images may contain models. Individual results may vary. Individual results are not guaranteed.