Scar revision and procedure

Wound healing characteristic varies from person to person. It depends on the person’s age, race, genetic factors and location of the wound on the body. There are several methods used to reduce the prominence of scars and improve the skins texture and flexibility. Technique of revision is chosen according to scars characteristics.

Whether caused by injury, surgery, or burn, scars can be disfiguring. Scars stand out against the rest of the skin because scar tissue is made of collagen cells which produce fibrous tissue rather than ordinary skin cells. As a result, scars are usually a different color, and do not have sweat glands or hair follicles. The severity of a scar depends on many factors, including the size and depth of the wound, the blood supply to the area, and the thickness and color of the skin. A wound including all skin layers leaves a scar which is inevitable consequence of wound healing process.



Linear scars which do not cover a large surface are surgically removed by cutting the skin around the scar, and wound is closed by fine and delicate stitch techniques in order to leave inconspicuous scar.

Dermabrasion can be performed for the superficial scars even which extend large surface. Dermabrasion smoothens out surface irregularities such as deep lines or scars by removing the topmost layers of the skin.

Tissue expansion can be considered for thick and irregular scars which even extend large surface on the body. Tissue expanders are silicone balloon in various shape and size which are placed underneath the skin where the expansion is required. In this procedure, an expander is inserted under a patch of healthy skin near the scar. The expander is inflated with a saline solution 1-2 times each week to stretch the skin. Inflation can be done in the office and is not painful. Inflation quantity depends on the size of the expander. Inflating period depends on the size of the expander and the volume of the saline solution added into the expander each time, but it usually takes 6-8 weeks. When the skin has been adequately stretched, the expander is surgically removed, the scar is then removed, and the balloon-stretched skin is pulled over the previously scarred area and carefully closed. This is a two staged procedure. After the second stage is completed, large scar become a thin linear scar.

Hypertrophic scars, which are thick, red, raised and occur within the edges of the wound. Keloids, which look like hypertrophic scars, but are firm and extend beyond the edges of the wound. Keloids can be swollen and often itch or hurt. Keloid formation depends on the person’s age, race, genetic factors and location of the wound on the body. When a keloid formation is anticipated, using silicone gel sheets and steroid applications may prevent the formation of keloid scars. These clear sheets are placed on the scar and wrapped firmly with tape. Steroids can help flatten and reduce the redness of hypertrophic and keloid scars. Steroids are applied or injected into the scar to break down the skin’s collagen. This is especially effective on hypertrophic and keloid scars, both of which continue to form collagen after the wound has healed. These injections can also help reduce the itching and or pain associated with these scars. Because of wound healing process may cause recurrence of keloid formation after surgery, surgery is not usually considered for keloids except particular cases. Surgery can only be considered for very firm keloids which cause to discomfort and dysfunction; and do not respond to medical applications.

While scar revision cannot make a scar vanish completely, scar revision procedures can diminish the appearance of scars, and help restore a damaged self-image. Sometimes the procedure can even improve the function of the site treated by easing the stiffness of the skin.