Scars are a visible outward reminder of a previous trauma or surgery. And while some people are completely at ease with their scars, for others they are an unwelcome reminder and can be a source of emotional or physical discomfort.
Scarring is unavoidable after surgery or a serious accident and the development of scars can be unpredictable. Scars may be raised or recessed, they may fade to become almost invisible or they may be very apparent.
They may vary in colour or texture from the surrounding skin and, depending where the trauma occurred on the body, they may be prominent and highly visible or hidden and barely noticeable.
If you have a particularly prominent or unsightly scar, or if scarring is affecting your confidence, you may wish to consider cosmetic surgery. The psychological impact of scarring can be particularly profound after a major injury, burn or cancer surgery.
How cosmetic surgery can help
As cosmetic surgeons we aim to improve or disguise the scar so you feel less conspicuous and more comfortable with your appearance.
Scar revision surgery is a well-tested and highly successful procedure that can help people to regain their self-esteem and improve their quality of life – sometimes significantly – by making the scar less conspicuous. After surgery, people often say they feel more confident particularly in social situations.
Scars tend to improve by themselves in time so we do not normally recommend scar revision surgery for at least six months after the original injury or operation to give the scar time to heal.
Types of scars
There are different types of scars that may require different treatments:
Normal scars can often be treated using micropore tape worn over the scar, day and night, for up to three months, or as advised by your consultant.
Hypertrophic scars may become red, itchy and raised. They may eventually settle down and become pale and flat or they may require treatment to speed up the healing process, including pressure tape, lycra garments or silicone gel. More severe scarring may respond to the application of steroid treatments or to a course of steroid injections every four to six weeks. Laser treatment is another option. Usually scarring becomes less itchy, paler and flatter after three treatments.
Keloid scars are scars that have healed abnormally, growing continuously and spreading beyond the original scar site. They can become raised, painful and itchy and may be the most disfiguring of all scars. Steroid injections normally produce improvements in around 80% of keloid scars. More stubborn scars may need scar revision surgery combined with steroid injections. The most severe keloid scars can become recurrent. These are normally treated with surgical excision followed by radiotherapy. The success rate of this type of treatment is around 90%.
Contractures are scars that restrict movement. This occurs when the skin and underlying tissue pulls together during healing, normally following a significant amount of tissue loss such as a severe burn. Contractures can also develop where a wound crosses a joint and may be treated with excision and physiotherapy.
How scar revision surgery works
Scar revision surgery is performed under local or general anaesthetic, depending on the extent of the scarring and where it is on your body.
The scar will be excised (surgically removed). We may use Z plasty – a plastic surgery technique that involves making Z-shaped incisions to improve the function and appearance of scars or W plasty which uses W-shaped incisions.
You will be advised how to care for your scar following surgery. Correct aftercare is important to the final result so it is important that you follow the instructions carefully so that the scar will heal fully over time.