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Frequently Asked Questions About Scar Revision
- What is scar revision?
- At what age can scar revision be performed?
- What does a typical scar revision consultation entail?
- How is scar revision performed?
- What should I expect postoperatively?
- When will the stitches be removed?
- When will I be able to see the results?
- What are the risks of scar revision?
- Are the results permanent?
Scar revision surgery or treatment lessens the appearance or removes traces of skin scarred during surgery or accidentally. There are a number of methods or types of scar revision, including silicone sheeting, which is noninvasive and requires only diligent use for many weeks or months to help fade the offending scar. Some invasive procedures require scar excision and reclosing the incision to help reduce the appearance or the scar or to reduce the stiffness or restriction of movement caused by the scar. Some scars may require Z-plasty, a more involved procedure that repairs the skin defect by making incisions across the scar and transposing the flaps.
2. At what age can scar revision be performed?
Scar revision can be performed at anytime and has no age restrictions.
3. What does a typical scar revision consultation entail?
After checking a few surgeons' backgrounds and credentials, you will make an appointment for a consultation. You will meet with these surgeons individually and discuss your goals. You will disclose all information regarding your health and any medical conditions you may have. You will discuss your concerns about your scar and the potential improvements that can be made. Your surgeon will explain the technique and incision placements that may be best for you, and the risks associated with it. He or she will also explain that a scar can be minimized but cannot always be eliminated entirely. You will also discuss the anesthesia to be used for your procedure if needed.
4. How is scar revision performed?
This depends entirely on your scar, its extent, and its location. For simple procedures, your physician may recommend less invasive means, such as silicone sheeting and gels. You must be dedicated in your application of these products and continue to wear them until the scar is greatly diminished or until your physician instructs you to stop. Silicone sheeting is not a miracle cure, but it can help prevent scars from becoming keloidal or otherwise pronounced. It can also help fade and flatten existing scars.
Some problematic scars such as keloids may be remedied somewhat by injections of a corticosteroid drug, which seems to break up collagen found in scar tissue. In very problematic cases of keloids, surgical revision will not be attempted for fear of worsening the existing condition of the scar.
Scar tissue lacks melanin, the substance that gives your skin its color and that darkens with sun exposure. If your scar is lighter than the skin around it, you may want to try micropigmentation. Micropigmentation is the art of implanting ink subdermally (think tattoo) into the lightened areas to match the skin around it. Be sure that your micropigmentation technician is skilled in scar revision tattooing and has photos of his or her work to show you. Scar tissue tattoos differently than unaltered (normal) skin. Be sure that you choose a natural color that you are able to easily maintain so that your result looks normal.
5. What should I expect postoperatively?
If you were sedated for your treatment, you may be groggy for the first day or two. You will have to take it easy for a few days. Bruising and swelling are a normal occurrence in most surgeries.
Although any discomfort should be alleviated by your prescribed pain medication, if you have excessive pain, redness, pus or other symptoms that do not appear normal, contact your surgeon. You must keep your treatment area out of the sun (including indirect sunlight and tanning beds) for about a year. Scar tissue takes approximately a year to mature . Sun exposure to scar tissue can cause collagen degradation, pigmentation problems, burns, permanent redness, and more.
6. When will the stitches be removed?
Suture removal depends on the treatment area. Count on somewhere between 5 and 14 days.
7. When will I be able to see the results?
Results are immediate; however, the old scar has been altered or removed and a new scar will be forming, so it is up to you and your surgeon to continue maintenance and therapy (silicone sheeting, corticosteroid injections) in some cases. It can take up to a year for the scar to fully heal.
8. What are the risks of scar revision?
If you are prone to keloids or have a history of keloidal scarring in your family, please let your surgeon know (although he or she may already know if your problem scar or treatment area is affected.) All surgery has risks and complications. With scar revision under anesthesia, these include an allergic reaction to the anesthetic used and infection.
Other risks include asymmetry, hematoma or seroma, bleeding, and general dissatisfaction. Numbness is also possible. It usually subsides within the first few months but may become a permanent issue. Puckering of the skin and indentations may occur. Excess scar tissue, stretching and lumps are possible as well. Please go over all the risks with your surgeon at your consultation and your preoperative appointment.
9. Are scar revision results permanent?
In many cases, yes. However, keloidal scars can reoccur.
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