Scar Revision

 

Scarring can have a powerful impact on the mind as well as the body. Whether the physical scarring is caused by trauma, a surgical incision, skin infections, burns or even poor healing, their appearance can lead to an array of issues with a person’s self-esteem — even hinder movement. So how can scar revision surgery, a non-surgical procedure or scar management program assist?

 

Of the many questions that are raised during a pre-operation consultation is on permanent scarring, a common concern for most patients. But the good news is that today’s technologies, scar revision surgery and the right scar management program can help minimise the appearance of scars. 

Your skin is your body’s largest and fastest-growing organ and it protects us from a range of infections. Though all scars are permanent, most will begin to fade over time, with the scar tissue becoming less pink and prominent. How they heal, however, will depend on a wide range of factors.

How Are Scars Formed?

When the skin’s tissue has been damaged in the dermis layer, the injured skin cannot regenerate. In its place, our bodies form new collagen fibres, known as scar tissue, which is a natural part of the healing process. Forming over the wound, the scar tissue will feature a different texture and colour from the surrounding tissue.

Of the different types of scarring — keloid, contracture and hypertrophic scarring are the most common examples of abnormal tissue response while chronic skin conditions such as extreme acne lesions may leave atrophic scarring [indentations commonly referred as an ice-pick scar].

Each can also be a painful reminder of a distressing experience or condition.

  • Acne Scars: The severity of the skin’s tone, textural changes and the depth of the indentations or raised scarring will determine the type of treatment required to stimulate collagen growth and tighten the skin.
  • Keloid Scars: These raised scars are common among dark-skinned people as a result of an overly aggressive healing process and in addition to overgrowing the boundary of the injury, the scarring may also obstruct movement.
  • Contracture Scars:  These scars are common with skin that has been burned and due to the depth of the scarring, often impairs movement due to damage to the muscles and nerves.
  • Hypertrophic scars. Similar to keloid scars in appearance, the raised and red scars, however, do not extend beyond the confines of the injury.

Scar Revision Treatments

The appearance and treatment of scar tissue depends on a manifold of factors including the location, size and depth of the wound on the body, the significance of the injury [trauma or surgical incision], any post-healing complications [including infection, bleeding or inflammation], the person’s age, ethnicity and skin texture, any pre-existing skin disorders or medical conditions, and their general health and lifestyle [such as diabetes, nutrition or smoking].

Performed on an outpatient basis, scar revision treatments may include:

Silicone sheets or a course of steroid injections to help thin, flatten and soften their appearance.

Microdermabrasion to help reduce and smooth the appearance of minor scarring.

Laser resurfacing to reduce the appearance of hyperpigmentation and smooth the texture of the scarred tissue.

Microneedling or advanced IPL [BBL Therapy] to trigger the production of collagen and smooth the surface of the scar.

Dermal fillers with hyaluronic acid [a water-binding gel] to help fill and blend the depressed scarring with the surrounding skin tissue.

Surgery such as excision to remove severe scars that are located deep in the dermis [and adding new layers of stitches to produce a new scar], Z-Plasty or W-Plasty to realign the scar tissue, skin grafts which involves transferring healthy skin from one part of the body to another, or flap surgery, a procedure that involves transferring healthy skin with attached fat, blood vessels and muscle, if required, from one part of the body to the other.

A topical ointment containing Vitamin E and cocoa butter and medical-grade skin care products for post-operative skin care.

The recovery period will also vary depending on the individual healing responses and the type of procedure performed. The scar will be covered with bandages and silicone tape to help the complete recovery process.

Patients may experience swelling, pain, tenderness and some redness following the surgery or treatment and will be asked to avoid strenuous activities during the post-recovery period [often up to a week]. A scar prevention management program will also be included in order to minimise the risk of infections and for the scar to heal.

This includes avoiding tight-fitting clothing, smoking and excess drinking, being vigilant with general hygiene and keeping the wound fully-protected from direct sunlight during recovery and applying SPF50 sunscreen thereafter.

And the end results?

Typically, patients will see a noticeable improvement within the course of a few weeks, with the results of the scar revision producing less visible or minimal scarring and greater confidence.