1. Scarred for Life
Although there is no way to completely remove a scar, it is possible to lessen its appearance through scar revision. This is accomplished through surgery. Before taking the surgical route, allow ample time for the scar to heal thoroughly, and apply topical steroids to lessen the itching, redness and tenderness of the scar. Scar revision is considered plastic surgery, so make sure you use a board-certified plastic surgeon.
2. Determine the Type of Scar
There are many types of scars, and some scars will eventually improve without surgery if given enough time. The surgeon will determine the type of scar you have to decide on the best course of treatment.
African-Americans and other people of darker skin tones can develop keloid scars, which are thick, darker than the surrounding skin and extend outside the edges of the injury. They are often found on the earlobes, shoulders and breastbone. Unfortunately, this type of scar can return even bigger than before after scar revision.
Other scars include facial scars caused by injuries, burns, acne and previous surgeries, and hypertrophic scars, which are red, thick and raised. Another type of scar is called a contracture. These scars are the result of burns or other major losses of skin. The surrounding skin is drawn together by the scar, limiting the movement of nearby muscles, tendons or connective tissues.
3. Making Your Scar Revision
The type of scar generally determines the scar revision procedure. Dermabrasion is a noninvasive procedure that sloughs off the skin surface. The plastic surgeon moves a high-speed rotating wheel over your face to remove the scarred areas.
Z-plasty gets its name from the Z-shaped design of the scar revision. In this procedure, the old scar is taken off, and tiny cuts are made in the skin around the scar. The skin is then stitched together in a different direction over the old injury.
Inpatient procedures for scar revision include skin grafting and flap surgery. Skin grafting takes skin from another part of the body and uses it to cover the scarred area. There is some scarring present in both places after the procedure. New scarring over the injured area means the graft was successful because new blood vessels have formed. Flap surgery transfers skin, fat, blood vessels and even muscle from one part of the body to the old scar.
4. Discuss Surgical Expectations
At your appointment, the plastic surgeon will examine your scar and discuss the appropriate type of scar revision technique, any risks and what to expect after the procedure. Possible complications from scar revision are bleeding, infection and the return of the scar. Clear up any concerns or questions that you may have before surgery so that your expectations are realistic.
5. Time Heals All Wounds
After your scar revision surgery, follow-up can take various forms. Again, time is needed before you see optimum results. Keloids may need additional surgeries every few years. Steroid injections are often done after surgery to keep hypertrophic scars from returning. Upon healing, skin grafts may look different in skin color from the noninjured area.
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