We often get a lot of great questions about the scar revision process. These procedures improve the appearance and/or the function of disfigured skin. It is a reconstructive process that can help to improve both the functionality and the appearance of scars that are one year old or older. You may find yourself considering scar revision if you have had a surgery or have been injured and have a lot of scarring. It is very important to enter the process with clear expectations, however. Scar revision is not going to erase scarring and it is essential that all patients are aware of that fact.
While the information in this article is meant as a basic guide, we encourage you to speak up! Please, at no time, assume anything about the procedure. Ask tons of questions and pay attention to the responses. It is imperative that you accept qualified medical advice and you should discuss your health needs or concerns at every stage of the process.
Please keep in mind that it is suggested to postpone surgery for at least a year after the scarring because scars change over time and doing it too early may be counterproductive to your goals.
How Do Scars Form?
They form in three basic stages:
- Inflammation. The inflammation starts right after the injury and lasts until the wound is closed; the inflammation is preventing infection. The wound isn’t sterilized until it is protected by a new external layer of skin.
- Transitional repair. This is when scar tissue is formed by the body in order to hold the wound together. This phase’s duration will depend a great deal on the nature of the injury or wound.
- Maturation. Maturation is the phase which typically starts about 7 – 12 weeks after the damage occurs. It is also the stage in which problematic scars may show up. Under ordinary circumstances, a repair process takes place. The new skin is developing and the scar tissue that was formed in the second phase of healing disintegrates.
A problem scar, which may require scar revision, will likely develop when the repair progression does not happen normally – for any number of reasons. We’ll talk more about problem scars in the next section.
Summary: Scars develop in three stages and problem scars are more likely to appear when those three stages are not allowed to happen uninterrupted.
What Are Examples Of Scars That May Require Scar Revision Surgery?
Not all scarring will require revision. Many scars will fade on their own and cause no mobility issues. These are types of scars that often do require revision:
• Hypertrophic scarring (raised and hard but not to the degree of the keloids)
• Keloid scarring (smooth and hard and has grown much larger than the original mark)
• Contracture scarring (skin is very tight and lack of mobility and pain can be issues)
Summary: There are 3 major types of scarring that are typically considered appropriate for scar revision – hypertrophic, keloid, and contracture.
What Are The Possible Scar Revision Surgery Procedures?
It is vital to recognize that no two scars are identical, and that different scarring will necessitate different considerations on the part of your doctor… and you. Here are a few of the possible treatment options your doctor may share with you at your consultation.
Dermabrasion
- minimally invasive
- softens the surface of the skin
- reduces irregularities
- similar procedures include chemical peel and skin bleaching
Skin Grafting
- basically, a skin transplant
- invasive procedure
- usually necessary for larger injuries
Tissue Expansion
- often used during breast reconstruction
- tissue is expanded (with a balloon of sorts)
- creates more skin for the doctor to use during surgery
Note: Very big wounds may require an operation to remove scar tissue and attempt to re-orient the scar.
Summary: Dermabrasion, skin grafting and tissue expansion are among the options for treatment of scars.
What Changes Should I Expect?
As stated above, never assume anything. If you are not sure what to expect, ask. If you still don’t understand, ask again. Here is some of what you may be able to expect from the surgery:
- You can expect improvement in skin tone and minimized discoloration. Unevenness in scarred tissue is very common. Scar revision surgeries can help make the skin tone more even and aesthetically pleasing.
- Interruption of scar lines can help to make scars less noticeable because a straight line of a scar is much more visible than a curved or softer line.
- Better mental health and self-esteem are often reported as patients are able to regain their body confidence.
Reduction in tightness and better function and mobility are an important goal in many scar revision surgeries.
Summary: You should expect improvement in appearance, functionality, and/or mental health – depending on why you initially sought out the procedure.
How Do I Prepare For Surgery?
The first and most important step will be setting up a free consultation to discuss the possibilities and your personal needs. No two patients are the same and any surgeon who is not willing to sit and answer any and all of your questions is not the physician for you. Find someone who makes you comfortable.
After the consult, consider the following prep steps:
- Before you come in for the operation, your surgeon will walk you through exactly how you will need to prep.
- It is advisable to all patients to prepare by getting plenty of rest and hydration while also mentally preparing.
- Address fears and concerns before the day of surgery. Set yourself up with reasonable expectations.
Summary: Prepping for surgery is a personal process that your doctor will help you with but be sure to have reasonable expectations.
What Should I Expect During The Recovery?
Recovery will vary depending upon many factors but the most important thing is to be in continual communication with your surgeon during the healing process. If you have inquiries, anxieties, or need medical care, call without delay.
Some basic things to expect:
- There will likely be inflammation, pain and discoloration for approximately 2 weeks.
- It is always wise to have somebody with you for the initial few days afterward.
- Drink plenty of water and get as much rest as you can.
- Exercise is fine, if your doctor allows it.
- Keeping the area out of the sun for roughly a year is also suggested.
- If the incision oozes or bleeds excessively, call your doctor.
Summary: While each patient’s healing process will be different, you should expect about 2 weeks of discomfort and a year of keeping your scar out of the sun. Always consult your doctor about recovery.
What Are My Next Steps Exploring Scar Revision Surgery?
An initial discussion with Dr. Shaher W. Khan (M.D.) will offer you a chance to talk about all of the questions you have about the operations we offer. Contact us here or call us at 734-419-1615 to get started with your scar revision solution. Dr. Khan serves the whole Detroit metro area.
Executive Plastic Surgeon
6850 Providence Pkwy
Suite 125
Novi, MI 48374
