Scar Revision Surgery

By Selena Gerrish

December 20, 2013Beauty & CosmeticNo comments

A facial scar can often affect a person’s self-esteem and self-image. It can also leave an indelible impression on people who see it. If the scar is not that big or it is hidden or you simply just have the confidence of Tina Fey, then it will not matter. But what if the scars are from a traumatic accident or a botched alteration, then it can have a big impact on your personality.
girl watching in mirrorWe all know that a scar is the body’s natural way of skin healing. Whenever a layer of the skin is injured, cut or divided, the body’s cells will automatically repair the damaged skin and rebuild tissues to close the wound. There are two categories of scars:

Hypertrophic scar

. It is a thick, red and usually a raised scar. This type of scar grows beyond the edges of the incision or wound. It is often dark or red in color as compared to the skin that surrounds it. The scar tissue can be removed or closed with one or more layers of stitches. Local anesthesia is applied before surgery and the patient can be discharged after the procedure.


This is similar to a hyperthropic scar except it extends beyond the area of the actual scar. Keloids are also thick and itchy clusters of scar tissues. Keloids usually happen when the body continues to produce fibrous and tough protein called collagen after the wound has healed. Keloids can be cut and closed with one or many layers of stitches. It is an outpatient procedure and local anesthesia is administered for the surgery.

What Is Scar Revision?

Surgical scar revision can be a cosmetic or a reconstructive surgical procedure available to patients that are faced with scars due to injury, trauma, burns or through another surgery. There are several factors that can affect the severity of the scars. These include wound size, the depth of the wound, the blood supply on the affected area, the skin’s thickness, skin color and scar direction.

You have to take note that no scar can be removed completely but plastic surgeons can improve the appearance of the scar or make it less obvious through injections, a photorejuvenation and a scar revision surgery. This type of scar usually manifest around the edges of the original wound or incision. The plastic surgeon will remove the excess scar and then reposition the incision to let it heal and as invisible as possible. It is also an outpatient procedure and local or general anesthesia is administered.

Available Procedures For Scar Revision

The type of scar revision will be based on the findings during the consultation. It will also determine what is the best procedure that will fit the patient. Options include:

Steroid injections and applications.

Steroids can help reduce and flatten keloid and hypertrophic scars. It can be injected or applied into the scar to break down the collagen which is effective in treating and stoping collagen production after the wound has healed. It can also reduce itchiness and pain that are linked to these scars.

Silicone gel sheets

Silicone gel sheets help flatten keloid and hypertrophic scars. The clear sheets are placed on the scar and left for 24 hours.

Tissue re-arrangements and Z-Plasty technique

Z-plasty is a technique used in re-orienting the scars. The scars are re-positioned by cutting the skin that surrounds the scar the scar in small triangle-shaped flaps. The flaps will follow a z-shape but the technique will depend on the shape of the scar. The flaps are then repositioned to follow the natural lines and skin creases.


This technique smoothens the surface irregularities like deep lines and scars by removing the topmost skin layer. Anesthesia will be injected into the target area and then a rotating wire brush or diamond wheel is used to remove the scar.

Vascular laser.

This works by shrinking the blood vessels that supply the scar. This will improve the redness of the scar tissue.

Tissue expansion.

The procedure involves inserting a balloon-shaped silicone sac that is inserted under a patch of healthy skin near the scar. The balloon is filled with a saline solution in stretching the skin. The balloon will be left for several weeks or months to adequately stretch the skin. Once the skin is stretched, the scar is removed and the balloon stretched skin is then pulled over the previously scarred area and closed.

Skin grafts.

The procedure involves taking healthy skin from the other parts of the body and transplanting the skin to the affected area. Skin grafts may not be pleasing to look at at first because the skin color may not match but in time, it will naturally blend with the surrounding skin. It will also restore function specifically to burned skin.

Laser skin resurfacing.

Two types of surgical lasers are used at present in reducing uneven surface scars, these are Erbium lasers and CO2 lasers. CO2 lasers are commonly used for deeper scars while Erbium is used for superficial scars.

Scar revision surgery can take about 30 minutes up to 2 hours depending on the type of procedure and the extent of scarring. A patient can go home after the procedure but can also have an overnight stay at the hospital if instructed by the plastic surgeon. Recovery time will depend will differ from patient to patient, the size of the scar, the patient’s skin condition and how well the wound heals.

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