Scars are the visible reminder of an injury to the skin. Scar revision is performed to improve the appearance of irregular, tight, or cosmetically unsatisfactory scars. Prominent scars may be thick, raised, tight, or irregular. Scars occurring as a result of trauma often appear worse because of the collateral damage to surrounding skin. Revisions may be performed once the area has completely healed to minimize additional trauma and improve the final scar appearance. Irregular or tight scars may be corrected to camouflage or release contracture of the skin.
Many issues may occur with scar formation including:
- Irregularities or discoloration
- Hypertrophic Scars: Thickened scars that may be wide, raised, and irregular.
- Keloid Scars: Typically an overabundant formation of scar tissue that grows beyond the initial injury. They may be large, thick, and prominent. They may cause itching, pain, or tightness.
- Scar Contracture: Scars heal with a process of contraction to shrink the size of the wound. These may be problematic in cosmetically sensitive areas or near joints where they may impair function.
Scar revision may start with injections of steroids to soften the scar or decrease itching. Surgery to re-excise and revise the scars is often required. Some patients will require plastic surgical techniques, such as a z-plasty or flap to lengthen scar contractures. Some scars may respond to fractional laser treatment to break up the scar. Keloid scars have higher incidence of recurrence in genetically prone individuals.