Scars are a normal part of healing of the skin following lacerations, incisions, tissue loss as a result of trauma of surgery. Scars have specific implications on individuals and produce significant and psychological, as well as social grievances. Most scars can be improved and made cosmetically more acceptable with scar revision surgery, when performed by expert surgeons.
Why consider scar revision surgery?
Scar formation is inevitable following skin injury, which may result from accidents, surgery, burns, acne and other forms of insult. Scars often compromise facial function, including the movement of eyes, mouth, or nose and are often aesthetically displeasing. Most people are self-conscious of facial scars. A scar, once formed is permanent. However, scars may be made less visible and more acceptable by surgically rearranging and/or relocating them; this also improves functional deficits, thus improving appearance, confidence and self-esteem.
Am I a suitable candidate for scar revision?
Patients in all age groups are suitable for surgery. Good general health, including psychological stability and realistic expectations, are prerequisites.
Benefits of scar revision surgery
Scar revision surgery re-orients and camouflages scars making them less visible thus improving the aesthetic appearance of the face. Benefits also include improvement in function and other untoward effects.
Limitations of scar revision surgery
Every patient considering facial scar revision must understand that scars cannot be removed completely. Surgery only seeks to improve the existing scars.
Skin type, colour, age, the type and depth of scar tissue and the original cause of the scar all play an important role. Timing of scar revision is also critical and revision earlier than 12 to 18 months is not usually recommended.
Consultation for scar revision
Whether the surgery is desired for functional or aesthetic reasons, your choice of a facial plastic surgeon is of paramount importance. During consultation, the scarred area is examined in detail and a surgical plan is made. Photographs will be taken to aid this process. Additional procedures, such as dermabrasion and laser treatment, are also discussed.
How successful is scar revision surgery?
In most cases of unfavourable scarring, results of scar revision surgery are satisfactory with the majority of patients expressing happiness with the results. Keloid scars generally do less well as they tend to recur.
How is scar revision surgery performed?
Surgery may be performed either under a general anaesthetic or under local anaesthetic. When a scar is of contracture type, as in cases of burns scars, all the scar tissue is removed completely at surgery and the area is covered with local skin flaps containing healthy skin. Where a flap is not possible, a skin graft may be used. For other types of scars, various strategies such as Z-plasty, W-plasty, dermabrasion and laser resurfacing are adopted as required. Keloid or hypertrophic scars are often treated first with injections of steroids to reduce their size. If this is not satisfactory, the scars can be removed surgically and the incisions closed with fine stitches. This may be followed by steroid injections every 6 weeks to dampen the re-growth of the scar.
Some discomfort after facial scar revision surgery is expected and adequate pain relief is given to keep you comfortable. Some swelling, bruising and redness is generally unavoidable. Stitches are usually removed within 7 days of surgery. You will be advised regarding restricting activity, lying with head elevated and the use of cold compresses. The end result of surgery is only evident after 1 year post surgery.
Complications are rare but include bleeding, infection and recurrence of scar tissue.
Consultations are under no obligation