Scars are inevitably part of a wounds’ or injuries' healing process. They occur after trauma or surgery and can form anywhere in your body from the face, ears, or legs. Sometimes, their bulging appearance can cause profound damage to self-image and esteem.
In some cases, these scars fade without intervention. However, in most cases, a scar revision is necessary to make the scar less conspicuous. It is one of the best ways to treat aesthetically unappealing scars.
Scar Revision Overview and BenefitsScar revision is a procedure used to address a visible or painful scar to make it less noticeable or less painful. While scar revision does not entirely erase the scar, it makes it less noticeable.
Yes!you’ll still have the scar, but it will be less visible and look smoother.
The goal of scar revision depends on the type of scar and your desired outcome. The process has numerous benefits, including:
- Correcting skin changes or disfigurement that result from a wound, an injury, poor healing, or even previous surgery.
- Eliminate scar tissue
- Minimize redness
- Restore bodily functions or the natural joint movement especially in contracture scars
- Reduce hypopigmentation or hyperpigmentation
- It reduces the scar size and helps it blend with the surrounding skin tone and texture.
Before you go for a scar revision, it’s recommended that you wait for a year or so from the date you got injured. During this waiting period, the scar’s appearance can dramatically reduce due to its natural healing process.
Scar Revision Techniques
Scar revision techniques can either be surgical or non-surgical. The scar type, size, and the treatment's purpose determine the best course of action to take.
For example, a minor scar-like acne can quickly disappear non-surgically, while larger and darker scars need a surgical scar revision. Scar revision surgery and non-surgical methods may be effective alone or in combination.
First, let’s explore everything you need to know about surgical scar revision.
Scar Revision Surgery
Scar revision procedure varies with the type of scar. For example, a keloid scar revision is different from an atrophic one. Also, the reasons for the scar revision differ. Some people do it for cosmetic reasons, while others aim to restore the functionality of the specific part of the body that the scar restricts or both.
So, what happens before, during, and after scar revision surgery?
Before the Scar Revision Surgery, How do you Prepare?
The plastic surgeon or the healthcare provider will prepare you for the surgery. Some of the advice that they may offer include:
- What to eat or avoid before surgery. For example, avoid eating or drinking anything after midnight when going for surgery the following day.
- Medicines to take or avoid on the day the procedure will occur - you may get an antibiotic through your IV fluids to prevent bacterial infection.
What Happens During the Scar Revision Surgery?
Finally, the day has come, and you’re all set for the operation. The procedure is usually pain-free as the doctors administer anesthesia, which can either be general (numbs the whole body) or local (numbs the surgery region only) anesthesia. You may feel the pushing and pressure during surgery with local anesthesia, but you’ll experience no sharp pain.
The operation involves making an incision around the scar to get rid of it. The surgeon may make several incisions on or near the affected area in a particular pattern. After surgery, he will stitch and bandage the area.
The scar size, type, location, and complexity affect the length of the surgical procedure. The procedure can take one to two hours. But, if the scar is large, hidden, or in an area that poses a challenge when operating on requires tissue repositioning, then the procedure will take longer than two hours.
What Happens After Scar Revision Surgery?
Besides the general discomfort after surgery, the affected area may look bruised, swell, or have skin discoloration. This can last up to one or two weeks after the surgery.
Your doctor will give you personalized instructions on how to care for the area. Following the instructions will help promote healing as well as mitigate discomfort. The scar improves gradually over the next several months and may take up to a year before it ultimately fades away.
Also, following the post-operative instructions can help avoid stretching or straining the scar. Use the right dressing or sunscreen to prevent skin color discoloration that occurs from sun exposure.
For contracture scars, doing physical therapy is vital to restore the affected body part’s regular bodily movements.
How much is scar revision surgery?
Scar Revision Surgery Cost
The scar revision surgery cost depends on different things, such as the doctor doing the procedure or the location. While most health insurance plans do not cover cosmetic procedures such as scar revision for a tummy tuck or breast augmentation, it’s good to check whether your health plan covers the procedure you want.
Ensure that your plastic surgeon is licensed, board-certified, and highly trained to carry out the procedure. Before you proceed with the procedure, exhaustively discuss with your doctor to understand the procedure outcome, risks, and benefits.
Risks of scar revision surgery
It’s not unusual to have some fears before going for an operation. Any surgery poses some significant risks. Here are some of the risks of scar revision surgery:
- Any invasive procedure poses a risk of excessive bleeding or getting an infection.
- The skin around the surgery area could become sensitive.
- Blood vessels and nerves around the scar could get damaged during the operation.
- You may develop a blood clot that may become life-threatening.
- Sometimes, even after this first scar revision process is complete, you may be required to get another after a while to improve the scar further.
Types of Surgical Scar Revision Methods
The procedure can either be through:
- Incision
- Tissue handling
- Layered wound repair
Scar revision surgical techniques may include:
- Fusiform elliptical excision- This is the most common technique. It involves revising spread scar or mature depressed scar, which is existent alongside the RSTLs.
- Z-plasty- This scar revision technique is based on geometrical tenets. The procedure not only makes the scar less noticeable but also changes the scar direction and aligns them to the RSTLS. It also helps lengthen the contracted or webbed scar and changes the displaced anatomical point’s position by depressing or elevating it.
Scar Revision Surgery After Care
Doctors recommend certain things as post revision care. They include:
- Nutrition
The variety of food that you consume can have an impact on your recovery process. It’s vital to eat a balanced diet and remain well-hydrated after surgical procedures. Some of the fluids that you can drink include water, yogurt, fruit juice, and milk. Eat a diet that has a high level of lean protein to promote healing.
- Avoid Smoking
Smoking is not only harmful to your health, but it also impedes the healing process.
- Elevation
Keep the scar elevated in a place above the hearts level. For example, if the procedure was done on your legs or any other lower part of the body, keeping the legs lifted will quicken recovery. If it’s the face, then put it in a reclining position.
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Wound care
The doctor may recommend some appropriate wound care around the surgical region. That includes a change of bandage or daily clean up. In some instances, the doctor may recommend leaving the dressing in place until the time for a follow-up visit. So, get the instructions clear from your doctor.
Also consider incorporating the things that will make the scar heal faster like masaging the scar.
Let’s now look at the non-surgical scar revision techniques.
Non-Surgical Scar Revision Procedures
In some cases, non-surgical procedures can effectively reduce scar appearance. These types of treatments work best for minor scars like acne scars.
The minimally or non-invasive scar revision methods include:
1. Topical Treatments
Topical products such as silicone gels and sheets improve contours, texture, and reduce the discoloration. The medications also help in the healing of the scar surface.
You can also lighten the hyperpigmented scar using kojic acid, hydroquinone acid, hydrocortisone, alpha-hydroxy, and retinoic acid. Topical application of products like mitomycin C 0.4 mg/ml and 1 mg/ml improves keloid and hypertrophic scar.
2. Injectable Treatments
Injectable treatments like fillers made from synthetic and natural ingredients help improve the sunken scars’ appearance.
On the other hand, steroid injections decrease collagen production, thus altering the raised scars’ appearance, texture, and size.
3. Surface Treatments
Surface treatment techniques help smoothen the surface of the scar. They also reduce the discoloration by getting rid of the dermis or the skin’s outer layer, allowing new skin to form.
Some of the best surface treatments include:
- Dermabrasion –This procedure involves removing the skin’s upper layer with a wire brush or device. It takes around fifteen to sixty minutes, depending on the size of the affected area. Scabs can start to fall off after two or so weeks. The pinkness may take up to three months to fade and between 6-12 months to see the final results
- Laser/light therapy - It involves exposing the skin to laser or light treatment to change the skin’s surface. A fresh and healthy skin grows after the treatment in the affected area.
- Chemical Peels
Chemical peels also improve the appearance of mild scarring. It involves the use of a chemical solution to remove the old skin's upper layer. The new skin that forms is smoother and even.
This is a cost-friendly option for scars’ appearance. It is a perfect procedure for light-haired and fairly-skinned patients.
