Scar revision is performed to reduce the appearance of scars caused by injury or previous surgery. Scars are by definition permanent, but surgery can narrow, fade and otherwise reduce the appearance of severe or unattractive scarring, which is especially helpful in areas of cosmetic importance such as the face and hands.
Types of Scars
There are several different types of scars that may be sustained, depending on the type and severity of the injury, as well as the patient's age, overall health and individual healing properties.
- Hypertrophic scars
Scar Revision Procedures
Scars are by definition permanent, but certain treatments can narrow, fade and otherwise reduce the appearance of severe or unattractive scarring, which is especially helpful in areas of cosmetic importance such as the face and hands. There are many surgical methods of scar revision, only some of which may be appropriate for a particular type of scar or its location. These include surgical excision, skin grafts, and flap surgery. The best procedure for each patient will vary depending on the location and severity of the scar, as well as the age, overall health and extent of revision desired by the patient.
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Subcision - Subcision is a procedure for treating scars that are depressed. A needle is directed into the skin to break up the fibers that attach the scar to tissue below the surface, raising it back to the elevation of surrounding skin. It also promotes healing in the area, creating new connective tissue that repairs and smoothes the skin.
Excision - Surgical excision is most often used for severe contracture scars, and involves making an incision to surgically remove the scar and surrounding damaged tissue with a scalpel. A skin flap or graft may be used to restore the appearance of the skin in the treated area and also improve movement and flexibility that may have been affected by the contracture.
Punch Elevation - Particularly effective for certain types of acne scars, punch elevation involves the use of a punch tool rather than a typical scalpel. This device can precisely remove small quantities of tissue without affecting the skin nearby. The punch tool is used to elevate the base of the scar, making it appear much less recessed or pronounced on the face.
Surface Treatments - Many cosmetic procedures, such as microdermabrasion, chemical peels and skin bleaching can effectively improve the appearance of discolorations and mild surface irregularities by gently removing the top layers of skin and rejuvenating the underlying layers for a restored appearance. Multiple treatments may be needed in order to achieve noticeable results.
Laser Treatments - Similar to surface treatments, laser treatments gently remove the damaged layers of skin to reveal new, restored skin underneath, while also stimulating collagen production for further gradual improvements. The precise technology used during laser treatments ensures that only damaged tissue is treated, while healthy surrounding tissue remains intact.
Fillers - Dermal fillers can be quite successful at "filling in" depressed scars and creating a smoother skin surface. Fillers are FDA-approved and safe for use by most patients. Many of the fillers are made from substances found naturally in the body or are synthetically made to mimic natural substances or stimulate collagen production. Fillers are injected directly into the skin of the targeted area to restore volume to the scar and reduce its appearance.
Results and Recovery from Scar Revision
Most of these treatments are minimally invasive and do not require any downtime. Patients may experience mild swelling, discoloration and discomfort in the treated area for one to two weeks, but will likely experience immediate, noticeable results and will no longer have to worry about the appearance of their scar. Full results may take several months to appear, but are usually long-lasting.
The effectiveness of scar reduction depends on a number of factors, including the nature of the injury, the body's healing mechanism, the size and depth of the wound, and the thickness and color of the skin.