Scar Removal and How It Can Change Your Life

As the skin repairs from any kind of trauma, unsightly scars may result. Scar revision surgery offers the chance to minimize and diminish the appearance of several different types of scars. This surgery can help to restore function and facilitate movement, boost confidence, and improve quality of life. 

Many of the most common types of scars are treatable with several simple scar revision techniques. While scar revision can be quite successful, it is also important to be aware of some of the risks and complications that can occur, as well as what is to be expected after the surgery, during the recovery period.

Thinking about the Scar Revision?

Scar revision is surgery undertaken to improve or minimize the appearance of scars. When scars inhibit proper movement and function – as sometimes happens with an old wound, poor healing, or from a previous surgery – scar revision can be quite helpful. Scar revision may also help you correct acne blemishes or pigmented irregularities.

Scar revision deals with mature scar tissue that has already healed. Though the recommendation varies depending on the scar, some scars should be revised within 60-90 days after healing while others should be revised a year or more after the fact. During the operation, scars may be removed, and the skin closed in a precise manner. Even if the scar cannot be removed entirely, it may be lighter, smoother, or easier to cover up. The method of treatment differs depending on the type, size, and depth of the scar and its position on your body. Some commonly used scar revision tools include skin grafts (skin taken from another part of the body, widely used for burn patients), excisions (scar removal), and dermabrasion or laser resurfacing.

Types Of Scars

The size and shape of a scar will influence the way that it can be revised. A few common types of scars include:

  • Keloids: Keloids are a type of smooth, hard, raised scar that is a different color and texture than the rest of the skin that occurs as a wound heals. They are caused by the growth of excessive scar tissue and can be larger than the original injury. People with darker skin are more prone to keloids. 
  • Contracture Scars: For burn victims, especially, contracture scars may impair movement due to the tightening of the skin over time. Depending on the severity of the burn, the scar tissue may go very deep, affecting joints, muscles, tendons, and nerves.
  • Hypertrophic Scars: Raised, red scars that do not extend beyond the original injury.
  • Acne Scars: Acne can leave behind different kinds of scars, from deep pits to some that look angular or wavelike. These scars are typically found on the face or back but can be in other places.

Why Should You Consider Scar Revision?

Scars are certainly a cosmetic issue. In highly visible places on the body, as with facial scar revision, for example, scars may provoke an unwanted response or dampen self-esteem. For others, scar revision may be an absolute necessity used to restore movement and substantially improve the quality of life.

Keloids, for example, extend beyond the edge of the original wound. Some thicker keloids can pucker and start to resemble unsightly tumors. At this point, although they may return, scar revision can remove them from where they meet healthy tissue. Scar revision is also quite beneficial for scars that are at an angle to the normal tension lines of the skin or have thickened over time. For burn victims with contracture scars, there is a scar revision technique that can improve the restriction in movement around the injured area.

Scar revision can offer the patient improved skin tone and texture. Skin discoloration is a common effect of scarring. Lightening or darkening the damaged tissue to match the rest of your skin can make a dramatic difference in appearance. Uneven skin texture caused by scarring can also be improved with scar revision techniques. 

Optimal Treatments For Scars

Outside of surgical revision, there are some excellent treatments that may prevent or minimize scar formation. Preventative care measures can include scar massage, pressure treatments, or silicone gel sheeting during the healing process. One or both of those treatments can heal fresh wounds and prevent scars, like keloids, or reduce scarring from severe acne.

Additionally, there are several over-the-counter or prescription creams, ointments, and gels that can treat cuts or wounds that are healing or have already healed. Applying these topical remedies can help to minimize or reduce scarring.

Steroid injections are used to treat raised scars like keloids and hypertrophic scars by reducing inflammation and evening them out. Conversely, for pitted scars, like those from acne, collagen or other types of “fillers” may be injected into the skin to plump it up. Unfortunately, these injections typically only offer temporary solutions.

How Is Scar Revision Surgery Performed?

Scar revision surgery may be done while sedated or under local or general anesthesia, depending on the type of surgery. Most surgeries employ one or a combination of the following modalities:

Dermabrasion: A kind of wire brush called a burr is used to remove the top layers of the skin to soften the surface of the skin and subsequently polish and reduce irregularities. New skin will grow over the area after treatment. 

Laser Resurfacing: A laser can soften the surface of a scar, potentially minimizing its appearance and promoting new collagen growth within it.

Z-plasty: For contracture scars like those due to burns, a Z-plasty can liberate muscles, joints, and tendons that are constrained by shrinking skin. During the surgery, excess scar tissue is removed. On both sides of the scar, a series of small cuts will be made and result in v-shaped skin flaps. The procedure works by thinning and minimizing the scar and possibly changing the orientation of the scar so that it follows natural skin fold patterns and releases the tension in the Scar. 

Skin grafting and skin flap surgery: When large amounts of skin are lost, or when a thin scar will not heal, skin grafting and skin flap surgery are used. Skin grafts are harvested from other parts of the body and placed over the wound to heal the area. With skin flap surgery, thicker pieces of skin that contain fat, nerves, blood vessels, and muscle are taken from healthy parts of the body and placed over the wound. Intensive scar revision surgery before and after can make quite a difference. Be sure to check out our gallery here.

Risks And Potential Complications Of Scar Revision Surgery

As with any medical procedure, there are a few common scar revision risks and potential complications. There is a risk that during scar revision surgery some patients may react negatively to any of the medicines or anesthetics, or potentially suffering from breathing problems. There is also a risk of severe bleeding, blood clot formation, and infection.  

While scar revision is often initially successful, some types of scars, namely keloids, may return after surgery. Additionally, as keloids are common in specific individuals as they heal, new ones may develop as wounds close. 

Recovery And After Care

Scar revision surgery recovery time varies due to the procedure and how quickly healing occurs. Most people can return to work or school soon after minor scar revision surgery takes place. 

Take care not to expose the scar to too much sun and to wear sunscreen on it to prevent darkening. If further scar revision is necessary, the darkening may complicate things a bit. 

For keloid revision specifically, a pressure garment or elastic dressing may be placed over the area to promote proper healing and to prevent it from returning.  Other types of scar revision require clean, light dressings to prevent infection. If stitches were necessary, they’ll be removed from the facial area within 3 or 4 days and from the rest of the body within 5 to 7 days after surgery.

How Will Scar Revision Improve Your Everyday Life?

  • Boost confidence: Scar revision on the face of a visible body part can be an incredible confidence booster. Without the constant worry of the attention that the scar attracts or that you pay to your Scar, you will likely feel more at peace with your body and more confident in your skin. For those who undergo facial scar removal or scar removal from any highly visible areas, scar revision can open new doors and enhance your quality of life.
  • Help heal emotional trauma: If the scars are the result of specific trauma, scar revision surgery can be a great way to move on with your life. Without the constant, glaring reminder, you can continue healing emotionally.
  • Resolve physical trauma: If your scars are impairing your ability to move, then scar revision can help restore joint mobility and increase range of motion that may have been hindered by a previous injury.

The Importance Of Finding A Qualified Surgeon In Chicago

Surgical scar revisions before and after can make a world of difference. These techniques can enhance day-to-day function, rapidly improve appearance, and boost self-esteem. 

Your satisfaction with scar revision treatment comes down to the overall skill, experience, and the sure hands of your surgeon. For scar revision in Chicago, consider Dr. Douglas M. Sidle, a board-certified facial plastic surgeon at Northwestern with expertise in the face and neck. From the initial consultation to the recovery process, Dr. Sidle’s team will ensure that you’ve received a safe and successful procedure. 

About Douglas M. Sidle, MD, FACS

Dr. Sidle specializes in cosmetic and reconstructive surgery of the face, head, and neck. His services range from minimally invasive office procedures with little to no down time to major operations leading to dramatic improvements in appearance. Dr. Sidle is one of a select group of cosmetic surgeons who are “double boarded”. He is Board Certified by the American Board of Facial Plastic and Reconstructive Surgery and by the American Board of Otolaryngology-Head and Neck Surgery.
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