Scar Revision

A scar revision is surgery to improve the appearance of scars.

Prominent scars can cause embarrassment and can lower self esteem. Though no scar can be completely removed, a scar revision will make it discreet, so that the chance of someone noticing it is greatly reduced.

There are various forms of scarring that can be of concern:

Hypertrophic scars – are highly visible scars that appear raised and thickened and are red in colour. They are contained by the confines of the original scar.

Keloid scars – have a similar appearance but grow out with the original scar. They tend to occur in darker skinned individuals and in areas such as ears or chest.

What does the surgery involve?

There are several techniques used to improve the appearance of a scar that include:

Intralesional excision – this is essentially a debulking of the scar which reduces the amount of scar tissue within the confines of the existing scar. This prevents the scar from becoming larger.

Z-Plasty – this re-orientates the scar so that it is hidden within the natural creases of the skin.

Steroid injections – can be used to thin the scar and these are repeated every 6 weeks until the scar flattens and the redness disappears. Steroid injections are carried out in the clinic with a short procedure using a very small needle. They can be very useful for itching or pain associated with these scars.

During the procedure local anaesthetic is administered in order to numb the area.

What are the risks and side effects of surgery?

Complications are infrequent and usually minor. However, no surgery is without risk and it is important that you are aware of possible complications so that you can make an informed decision. These include:

Pain – occurs with every operation. The local anaesthetic will start to wear off after a couple of hours. After this time you may feel some pain. You may need painkillers such as paracetamol or ibuprofen and you can purchase these from your local pharmacy.

Bleeding – can occur either during or after surgery. This is usually very little but may cause bruising or temporary swelling under the skin. If the swelling is tense then the sutures may need to be released and the haematoma (blood clot) evacuated.

Infection in the surgical wound – which may need treatment with antibiotics. This, however, is uncommon.

DVT/PE/fat embolus – following any surgical procedure it is possible to develop a blood clot in your legs, which could potentially break off and move to your lungs. If the blood clot is large enough it could prove fatal. In order to reduce any risks of this we give you special stockings to wear in bed and a blood thinning injection if you are not mobile.

Unsightly scarring – certain patients can be predisposed to form thick hypertrophic or keloid scars and even revising the scar does not mean that it will not happen again.

All the risks will be discussed in detail at your consultation. However, if you have further questions or concerns, do not hesitate to contact me. Decisions about cosmetic surgery should never be rushed.

What happens after the operation?

At the end of the procedure, a light dressing may be applied.

As long as you are feeling well after the operation, you will be able to go home.

You will be unable to drive yourself home from hospital, so it is often a good idea to get a friend or family member to drive you.

Post-Operative Instructions

You will be given a full set of instructions before you leave. You should keep the area dry to prevent the dressing falling off. You can normally return to full activities the next day, although be careful not to injure the area.

What is the estimated time for recovery, absence from work and return to usual activities?

If you are feeling well and your surgery is not in a difficult area then you can return to work as soon as you wish. Try to avoid repetitive strain at the surgery site for the first couple of weeks, as the scars will still be weaker than normal skin and there is a chance they could stretch or even split open.

What follow up will I have?

You will be seen in the nurse led clinic 1 week later to check everything is healing and remove any sutures and dressings if necessary. I will review you at approximately 4-6 weeks or sooner if you have any problems.