Scar Revision Surgery

What is it?

Scar revision surgery is a way of minimizing a scar so it appears less obvious and blends more naturally with the surrounding skin. Depending on the size, type and location of the scar you may be able to have:

  • A simple, topical treatment
  • A minimally invasive procedure
  • Scar revision surgery
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    • Topical treatments – including gels, tapes and external compression – to promote healing and wound closure and to inhibit the production of pigment. Suitable for surface scars and discoloration.
    • Injection therapies – such as dermal fillers – effective for depressed or concave scars. The results may last from three months to several years before needing to be repeated. Steroid-based injections reduce collagen formation and can alter the appearance, size and texture of raised scar tissue.
    • Surface treatments – used to smooth surface irregularities and reduce uneven pigmentation. Some surface treatments remove the top layers of skin to allow new, healthy skin to form. These treatments include:
      • Dermabrasion: effectively polishes the skin.
      • Laser or light therapy: alters the surface of the skin to encourage new, healthy skin to form at the scar site.
      • Chemical peel: penetrates the skin’s surface to smooth irregularities in texture and colour.
      • Skin bleaching agents: lightens the skin and reduces pigmentation
    • If the scar is in an area of the body where there is a high degree of movement, a technique called layered closure will support healing both above and below the surface of the skin. Absorbable sutures are used for sub-dermal closure (below the skin surface).
    • Complex flap closures can reposition scars to make them less conspicuous or improve flexibility where contracture is restricting mobility.
    • In the case of severe burn scars, pharmaceutical tissue substitutes are used.
    • Tissue expansion is an alternative to conventional skin grafts. An inflatable balloon called a tissue expander is placed under the skin near the scar site. Gradually, the balloon is filled with sterile solution to expand the area of healthy skin. Once the skin has been stretched sufficiently, it is used to replace the scar tissue.

What to expect

Scar revision can improve the condition or appearance of scars anywhere on your body. Among the scars we can treat are:

  • Surface irregularities – for example, acne scars and minor scars. We offer cosmetic improvement to smooth skin and minimise discolouration.
  • Hypertropic scars – these are thick clusters of scar tissue that can become uncomfortable and hyperpigmented (dark red). They are often raised and uncomfortable and may worsen over time.
  • Keloids – these are larger and lumpier than hypertropic scars. They can be painful or itchy, and an appearance concern due to size. They are most common in areas where there is little underlying fatty tissue, such as on the face, neck, ears, chest or shoulders.
  • Contractures – some scar restrict movement. These are called contractures and they occur when the skin and underlying tissue pulls together during healing. They are when there is a large amount of tissue loss, such as after a burn. Contractures also can form where a wound crosses a joint, restricting movement of the fingers, elbows, knees or neck

What results can be achieved?

Scars are an inevitable result of healing after injury. However, if a scar does not heal well you can be left with a scar that is conspicuous and disfiguring. Scars may differ in colour and texture from healthy surrounding skin. They may be in a particularly obvious place or particularly large or obtrusive.

Scar revision therapy can make scarring less conspicuous, helping the scars to blend in with the surrounding healthy tissue. Some techniques work at a sub-dermal (below the skin) level to promote deeper healing. If you have scarring that makes you feel self-conscious or uncomfortable, we can discuss the different options available to you.

Possible risks

All surgery carries risks and cosmetic surgery is no exception. Fortunately, there are less significant complications associated with scar revision treatments, which are commonly performed procedures. However, with further possible scarring from revision, careful monitoring is often needed.

After surgery

Initially there will be some localised swelling and discomfort following all scar revision treatments. This should lessen after one or two weeks. With dermabrasion, chemical peel and laser resurfacing, there will be increased sensitivity and tenderness to the treated area.

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Common risks

The risk of most types of cosmetic surgery is similar and these will be discussed with you during your consultation. You can help to minimise certain risks by following your surgeon’s advice and instructions after surgery. Some of the common risks include:

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  • Minor discomfort – this can be treated with over the counter painkillers.
  • Minor swelling and bruising – your surgeon will advise you how long this will last based upon your individual procedure.
  • Skin sensitivity
  • Skin contour irregularities
  • Skin discoloration and swelling
  • Scarring – initially the scars will be red but they will fade over time to be virtually invisible.
  • Dissolving skin stitches not holding properly – if this occurs the stitches may need to be removed under local anaesthetic.
  • Stitch granuloma – sometimes a tender lump or abscess can occur at the stitch site. This is generally more common where the skin is thinner, such as in front of or behind the ear. The stitch may need to be removed or it may be treated with antibiotics.

Your surgeon will give you aftercare advice to help you to mitigate any symptoms and promote more rapid recovery.

More serious risks
The symptoms listed above are normally temporary or without serious consequences. There are some more serious risks associated with cosmetic surgery, which will be discussed with your surgeon as part of the initial consultation.

Plastic surgery alone cannot change your life but it can give you the confidence to make those changes for yourself.

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