Scar Revision
Minimize a Scar
Scar revision surgery will attempt to minimize a scar so that it is less conspicuous and blends in with the surrounding skin tone and texture.
What are the steps of a scar revision procedure?
Step 1 – Anesthesia
Medications are administered for your comfort during the surgical procedures. The choices include local anesthesia, intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you.
Step 2 – The treatment
The degree of improvement that can be achieved with scar revision will depend on the severity of your scarring, and the type, size and location of the scar. In some cases, a single technique may provide significant improvement. However, your plastic surgeon may recommend a combination of scar revision techniques to achieve the best results.
Topical treatments, such as gels, tapes or external compression, can help in wound closure and healing, or to reduce the ability of skin to produce irregular pigment. These products may be used to treat existing surface scars and discoloration, and to aid in the healing of scar revision procedures.
Injectable treatments may also be used. Dermal filler can be used to fill depressed or concave scars. Depending on the injectable substance used and your particular scar conditions, results may last from three months to several years. Therapy must be repeated to maintain results. Another form of injection therapy uses steroidal-based compounds to reduce collagen formation and can alter the appearance, size and texture of raised scar tissue.
Surface treatments are most often used for cosmetic improvement of scars. These methods can soften surface irregularities and reduce uneven pigmentation. Surface treatments are a controlled means of either mechanically removing the top layers of skin or changing the nature of tissue. These treatment options include:
- Dermabrasion is a mechanical polishing of the skin.
- Laser or light therapy causes changes to the surface of the skin that allow new, healthy skin to form at the scar site.
- Chemical peel solutions penetrate the skin's surface to soften irregularities in texture and color.
- Skin bleaching agents are medications applied topically to lighten the skin.
Step 3 – Sometimes for deeper scars an incision is needed to surgically remove the old scar
Step 4 – Closing the incisions
Some scars require layered closure. Layered closure is often used where excision extends to tissue below the skin surface or in areas with a high degree of movement. The first step, or layer, requires sub-dermal closure (below the skin surface) with absorbable or non-removable sutures. Layers of closure continue to build, concluding with closure of the remaining surface wound.
Advanced techniques in scar revision include complex flap closures and W-plasty or Z-plasty techniques. Flap closures may reposition a scar so that it is less conspicuous or improve flexibility where contracture has restricted mobility.
Pharmaceutical tissue substitutes may be used if ample healthy tissue is not present for closure of a scar excision. This is more likely with revision of severe burn scars.
Tissue expansion can be a substitute for skin grafts. In this procedure, an inflatable balloon called a tissue expander is placed under the skin near the scar site. Over time, the balloon is slowly filled with sterile solution to expand the area of healthy skin. Once the skin has been stretched sufficiently, the expander and the scar is removed and the stretched skin is moved to replace the scar tissue. This process can involve multiple surgical stages or procedures in order to achieve the final results.
Surgeons In Your Area
Timothy Mountcastle
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Shlomo Widder
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U.S. Board Certified 8100 Boone Boulevard, Suite 730Tysons Corner, VA 22182
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Reza Miraliakbari
U.S. Board Certified Suite 310, 8501 Arlington BoulevardFairfax, VA 22031
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Wendy Gottlieb
U.S. Board Certified Suite 418, 1800 Town Center DriveReston, VA 20190
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Timothy Mountcastle
U.S. Board Certified Suite 430, 44095 Pipeline PlazaAshburn, VA 20147
United States
Shlomo Widder
U.S. Board Certified Suite 630, 8230 Leesburg PikeVienna, VA 22182-2641
United States
Munique Maia
U.S. Board Certified 8100 Boone Boulevard, Suite 730Tysons Corner, VA 22182
United States
Reza Miraliakbari
U.S. Board Certified Suite 310, 8501 Arlington BoulevardFairfax, VA 22031
United States
Wendy Gottlieb
U.S. Board Certified Suite 418, 1800 Town Center DriveReston, VA 20190
United States