Scar revision surgery

Scar revision surgery refers to a group of procedures and surgical techniques which are designed to give scarred skin surface an improved appearance by partially removing scar tissue or repositioning it in such a fashion that the scar becomes less noticeable. Depending on whether the patient’s expectations are to enhance aesthetic features or to restore functioning, scar revision may be considered to be either a cosmetic procedure or a reconstructive surgery.

The extent of the obviousness of scars is determined by several factors: if a scar develops in the shape of a straight line, is depressed or elevated, shows discolouration compared to the surrounding skin or pulls the skin to a certain direction, then it becomes more visible. The principal concept of scar revision is to smooth skin surface and reduce these irregularities to the point where the wound can barely be seen. If you have a scar on your face or any other part of your body that is difficult for you to bear, scar revision surgery may be the way of gaining back your self-esteem and erase emotional scars.

Basic types of scar revision

Besides surgical approach, there are several alternative nonsurgical methods that can be used to strengthen the results of surgery and to maximise healing. During an initial interview your surgeon, after evaluating your health status and examining your scar and medical history in detail, will discuss your desired outcome and explain your options. With all this knowledge in mind, he or she will be able to suggest a certain method since selecting the ideal procedure is highly individualized, being influenced by the size, extent, location and direction of the scar, as well as the skin tone, age and nutritional status of the patient. To be informed about your personal options be sure to make an appointment with one of our extensively trained specialists.

• Surgical excision is utilized mainly on large scars and means the direct surgical removal of scar tissue to reduce the size of the scar. When carried out in stages it is referred to as a serial excision.


• Z-plasty and W-plasty are surgical procedures to break up the straight line of a scar and reposition it along the natural creases of the skin. In the case of Z-plasty, the surgeon makes two little cuts on both sides of the scar, connects them with a third incision running along the wound and rotates the scar. W-plasty is for longer scars and it makes a straight line irregular by using numerous small cuts to form a zigzag pattern


• Geometric broken line closure, a variety of W-plasty, places squares, trapezoids and triangles across the scar so that the eye has more difficulty following the incision line


• Skin grafting involves taking a thin layer of skin from a healthy part of the body and placing it over the injured tissue


• In skin flap surgery a section of skin containing blood vessels, nerves, fat and muscles is taken


• Laser skin resurfacing and dermabrasion are known as ablative skin treatments because they smooth and soften the surface of raised or uneven scars by removing the upper layer of the skin. When performing dermabrasion the surgeon treats the scar tissue with a special instrument equipped by a high-speed rotating wheel. Laser skin resurfacing, on the other hand, evaporates the top layer of skin by laser rays


• Tissue expansion stretches the skin by inserting a silicone balloon beneath it and gradually filling that with salt water. It is used for reconstructive purposes such as breast reconstruction or for skin damaged by injuries or birth defects

When to expect the final results of the procedure

Following the initial injury, scars need a period of at least one to one and a half year to reach their mature form and to become suitable for surgery. As the applied techniques, the result and the amount of time needed for recovery is strongly dependent on the characteristics of the scar and the person who bears it. In general, it can be stated that if you carefully follow all the instructions given by your doctor, you can significantly improve the healing period and the outcome. During the early phase of recovery the scar will look more intense but within some months it begins to fade and in about a year’s time your scar will have been diminished to the extent that it can hardly be noticed.

If you want to learn more about your scar and your opportunities of treating them, be sure to contact us and ask for a consult.