Scar Correction
What is scar correction?
Scar correction is a procedure used to make a scar, caused by trauma or surgery, less noticeable and it is one of the most common procedures performed on the face. The formation of a scar is a normal tissue response to injury and is expected after any skin damage, including surgical incisions.
The appearance of a scar depends on the cause of the wound, the materials and instruments used for its closure, the surgeon’s skill, as well as the patient’s age, skin quality, complexion and individual healing response. The way a scar looks immediately after a wound is treated or a surgery is performed is not final. Over time the scar is expected to blend more closely in color and texture with the surrounding skin.
Scar revision is not recommended within the first six months after the scar appears, as it takes time for the scar to reach its final form.
Is scar correction right for you?
Every surgical procedure results in a scar and every scar revision ends with a scar as well. However, the goal of scar revision is to create a more aesthetically pleasing or less noticeable scar. Some individuals react to skin injury with excessive scar formation, a condition known as hypertrophic scarring or keloids. In such cases, surgical correction must be approached with caution as it can potentially lead to an even larger and more prominent scar.
The purpose of scar correction is twofold. An unattractive scar, either raised above or sunken below the skin level, can be surgically removed and sutured again. Alternatively, a scar can be surgically concealed. Before deciding on scar correction it is essential to consult a surgeon. You should understand what kind of results to expect from the proposed procedure and the timeline for those results.
In some cases surgical correction is not the only option; it is often combined with dermabrasion or chemical peels to achieve the best possible outcome.
When is operation needed?
Choose a qualified surgeon you trust. During the consultation, in addition to examining the scar, the surgeon will assess your skin type and take photographs to evaluate the success of the procedure afterward. You should discuss with your surgeon the possible risks of the procedure and any conditions that may affect the surgery, such as blood pressure, medications that can affect blood clotting, allergies, smoking, scar tendencies and similar factors. For the procedure to be successful, and to make a well-informed decision, it is crucial to realistically assess its benefits together with your surgeon.
Once you and the surgeon have decided to move forward, they will explain the surgical technique, the type of anesthesia, the duration of the procedure, post-operative care and the follow-up process after surgery.
Understanding the surgery
Wide, recessed or raised scars that follow the natural folds of the skin are surgically excised with a margin no wider than 1 to 2 millimeters. After the scar tissue is removed and small blood vessels are coagulated the healthy surrounding structures (skin, subcutaneous tissue, and muscles) are carefully separated. Each of these layers is then sutured individually. For the procedure to be successful it is essential that the final skin sutures are placed without tension. This ensures the resulting scar remains narrow and avoids the formation of visible suture marks that may indent the skin.
Scars that run perpendicular to the natural folds of the skin must be surgically camouflaged. This camouflage is achieved by excising the scar in a way that creates broken or irregular lines. Such lines help reduce the visibility of the scar. There are two main surgical techniques used for this purpose: multiple “W” plasties and geometric broken line plasties.
After the procedure, the wound is covered with a thin layer of antibiotic ointment to ease cleaning.
What happens after surgery?
Most procedures are performed under local anesthesia and the patient is typically able to leave the hospital the same day. If the procedure is performed under general anesthesia an overnight hospital stay is usually recommended. Once the anesthesia wears off the patient may feel mild pain and the doctor will advise which medications to take for relief.
If a dressing has been applied it can usually be removed the day after surgery. The patient is advised to rest with their head elevated and to apply a cold, dry compress to the wound to help reduce postoperative swelling. Strenuous physical activities should be avoided.
For wound care saline is recommended for cleaning, followed by a thin layer of antibiotic ointment. Stitches are typically removed between the fifth and seventh day after surgery.
Recovery usually takes between 10 and 14 days. There are many creams available on the market that can accelerate scar maturation. Patients should consult their doctor before using any of these products.
The appearance of the scar is not evaluated immediately after stitch removal. A final assessment of the surgical outcome is made approximately six months after the procedure.
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