Scar revision surgery

When the skin is damaged due to an accident, surgery, or burn, it heals through tissue regeneration and scarring. Superficial skin injuries heal invisibly, but deeper wounds leave scars. An experienced plastic surgeon can help improve various scars using diverse methods.

The appearance of scars is influenced by many factors, such as the tendency for scar growth and their location. On stretchable areas like the back or joints, scars may spread more. Wide and sunken scars can also form if a surgical wound becomes infected, reopens, or is under tension. A spread scar can often be improved with surgery, supportive sutures, and subsequent taping therapy.

Tight scars can be corrected using techniques like Z-plasty, which improves skin mobility and reduces both cosmetic and functional discomfort. Scar revision surgery is safest after the scar maturation process, approximately 6–12 months after the scar forms. If a scar is operated on earlier, it may result in an even more problematic scar.

Sometimes a scar can grow raised, hard, and red, known as a hypertrophic scar. A keloid is an overgrown scar that extends beyond the edges of the original wound onto surrounding skin. The tendency for hypertrophic and keloid scars is hereditary and most commonly occurs on the shoulders, chest, and earlobes.

Preventing scar overgrowth involves avoiding tension and using wound tape, often for six months. Silicone-based scar gels may also help. If redness or overgrowth occurs, keloid scars can be treated in various ways.

Abnormal scars can be removed surgically, and after removing the sutures, the growth of a new scar can be controlled with silicone sheet therapy. If necessary, the scar area can also be treated with corticosteroid injections. Additionally, plastic surgeons may use laser treatments for scar revision.

• Consultation: After discussing with a plastic surgeon, who evaluates the type and location of the scar and your preferences, the surgeon explains the different treatment options and recommends the best method.
• Surgery planning: Scar revision surgery is planned based on individual needs, aiming for the most natural and inconspicuous result.
• Lifestyle improvements: Quit smoking at least two weeks before surgery and maintain good physical condition. Being overweight increases the risk of complications.
• Support: Ensure you have help with household tasks and shopping during recovery.

During recovery, it is important to follow all the doctor’s instructions and attend follow-up appointments as needed. Recovery is individual and depends on factors such as the scar’s location, the extent of the surgery, and the patient’s overall health.

• Immediate Recovery: In the first few days, the operated area may be tender, swollen, or tight. Avoid physical strain and stretching the skin. Pain relief and cold therapy can be used if necessary.
  
• Hygiene: The wound is protected with a dressing, and hygiene is carefully maintained.
  
• Suture Removal: Sutures are usually removed about 1–2 weeks after the procedure. The wound closes, and the skin’s surface layer begins to heal.
  
• Scar Maturation: In the following weeks and months, the scar may be red, raised, and itchy. Over time, the color fades, and the surface smoothens – this process often takes 6–12 months.
  
• Aftercare: After suture removal, silicone sheet therapy or corticosteroid injections can be used to control scar growth. Aftercare may also include other methods, such as laser treatment or chemical peels.
  
• Sun Protection: Protecting the scar from the sun is important to prevent darkening.
  
• Restoring Mobility: If the scar is in an area affecting mobility, such as near joints, physiotherapy may be recommended. Movements are restored gradually according to the plastic surgeon’s instructions.
  
• Follow-Up: A follow-up visit is usually scheduled within a couple of weeks after surgery to assess scar healing and provide additional treatments if necessary.