Scar Revision: Frequently Asked Questions
If you're considering scar revision, you probably have lots of questions and a few concerns. We've assembled some of the most frequently asked scar revision questions and their answers:
- What is scar revision?
- At what age can scar revision be performed?
- What does a typical scar revision consultation entail?
- How is laser scar revision performed?
- What should I expect postoperatively?
- When will I be able to see the results?
- What are the risks of scar revision?
- Are scar revision results permanent?
- What are the alternatives to laser scar revision?
Scar revision reduces (but does not totally obliterate) the appearance of scars and helps to prevent certain types of scars from recurring, including raised, red keloid and hypertrophic scars. Today, the gold standard for scar revision is laser scar removal.
Scar revision can be performed at any age.
A scar revision consultation involves meeting with a board-certified plastic surgeon or facial plastic surgeon to discuss your options. You should discuss your scar revision expectations and listen carefully to any comments the doctor makes regarding what can be achieved realistically. Expectation management is important when it comes to scar removal because no scar can be removed completely. The doctor should review your medical history and examine your skin and scar before determining the right treatment. He or she should also discuss the risks, cost and recovery period associated with scar revision.
Laser scar revision is generally done under local anesthesia, but extreme cases can call for general anesthesia. Your doctor will have already chosen one laser from among several used for scar revision (CO2, Er:YAG, fractionated and pulsed dye among them). He or she will move the laser along your scar, removing a layer of skin and exposing a new layer which will, as it heals, minimize the scar's appearance. Some lasers, like Fraxel, stimulate the production of new collagen that corrects the scar from the inside out. Steroid injections may also be used to help flatten the scar.
Depending on your tolerance for pain and the type of laser used, you may experience some discomfort following laser scar revision. Your doctor will provide you with a list of aftercare instructions, including how to clean and care for the treated area.
You should begin to see results within the first week after treatment, but it can take up to a year for the scar to fully heal.
The risks of laser scar removal include changes in skin color (hyperpigmentation or hypopigmentation), infection, and a general dissatisfaction with the results.
Generally, they are permanent, but keloid scars can recur.
Other than laser scar revision, other options include noninvasive silicone sheeting/gels that over time fade and flatten the scar, steroid injections to reduce the appearance of certain scars, punch grafts in which small pieces of normal skin replace scarred skin, surgical excision, and Z-plasty, a plastic surgery procedure that camouflages the scar by repositioning it within a natural skin fold. Chemical peels and dermabrasion are also used to reduce the appearance of scars.