Scar Removal and Scar Treatment
The first thing to appreciate is that once you have a scar it’s not possible to completely remove it without leaving a trace. However on a more positive note there is a lot that cosmetic surgery can do to improve the appearance of a scar.
It is possible to reduce the size of a scar, to alter its position so that it is less noticeable, smooth out contours and minimise skin redness.
How does a scar occur?
Whenever a wound is made in the skin, the subsequent healing process will result in a scar.
The wound-healing process begins with inflammation, progresses to tissue formation and ends with modifying specific factors in the anatomy – such as collagen, the main protein found in connective tissue that supports the skin, bone, cartilage and blood vessels.
Many factors contribute to the size, shape and quality of the final scar. These include whether the scar was made intentionally through surgery or accidentally through some type of trauma. If the conditions are favourable for good scar formation, all that may be seen after time is a fine white line. However in less ideal conditions the scar may be wide, thick and sometimes raised, red and bumpy. The latter type is known as ‘hypertrophic scarring’.
In the past surgeons tried to avoid operation on hypertrophic scars. Surgical intervention, in many cases, only made things worse. Today new techniques and advancements have enabled cosmetic surgeons to be more successful with scar removal or scar revision.
Who is most likely to suffer from scarring?
Growing children, adolescents and young people with tight skin tend to produce larger, raised, red scars. Conversely, older people and young babies have a lower risk and tend to form the least visible scars.
Those with pigmented or thick skin. Certain racial and ethnic groups are predisposed to more severe scarring. These include Chinese, Pacific Islanders, Black Americans and Africans.
Scar Removal and Scar Treatment Options
Surgical Scar Removal
A scar removal operation can be very time consuming as meticulous care is needed to produce the optimal result.
Depending on the many factors that affect wound healing, the surgeon may be able to revise and minimise a hypertrophic scar by means of a simple excision and closure. This allows healing to occur in a more favourable environment with a more predictable outcome than the initial scar.
Scar removal surgery is generally not carried out until several months after the initial surgery as it is generally best to let scars settle for as long as possible before trying to correct them. The procedure can often be carried out in a hospital on a day stay basis using local anaesthetic and sedation.
However sometimes there is no point in trying to improve the quality of a scar by simply excising the old scar and carefully closing the old scar in the same direction. If the conditions were favourable in the first place they are unlikely to improve considerably in the second or even third place. Other more complex techniques like the multiple W-plasty and Z-plasty procedures may be more appropriate in these cases.