Facial Scar Revision

Surgery of Facial Scars

With very few exceptions most people are self-conscious about facial scars. When the skin is in the process of recovering from an injury, whether the result of an accident, surgery, a burn, or acne, scarring will occur wherever multiple layers of the skin have been affected. Some people may also experience diminished functioning of the eyes, mouth, or nose due to scarring. Once a scar forms, it is permanent but may be made less visible or relocated surgically to improve your appearance, your self-confidence, or your level of facial functioning.

Is Facial Scar Treatment For You?

A person considering facial scar revision must understand that there is no way to remove scars completely. The goal is to improve the appearance of the scar either by disguising it, relocating it, or minimizing its prominence. Skin color and type, age, and the type of scarring, are all important factors that must be part of the discussion prior to surgery.

Different types of scars respond to different plastic surgery techniques. Timing of surgery is another important choice. Some surgeons advise against any scar revision in cases of injury for a period that might extend up to a year after the injury. This interval allows the body enough time to heal fully.

Making The Decision For Scar Treatment

Different scars require different treatments. Keloid scars are a result of the skin's overproduction of collagen after a wound has healed. These scars generally appear as growths in the scar site. Hypertrophic scars, unlike keloids, do not grow out of the boundaries of the scar area, but because of their thick, raised texture, can be unsightly and may also restrict the natural movement of muscles and tendons.

Some facial scars are unattractive simply because of where they appear on the face, while others affect facial expressions. All surgical possibilities will be discussed in the initial consultation along with risks involved for each type of scarring. The agreement between you and Dr. Majmundar on how to proceed is a prerequisite for successful surgery. After you both decide to proceed with scar revision, he will inform you about the anesthesia, the surgical facility, any supportive surgery options, and costs. Because scars are highly individualistic and the patient's attitude toward scars is so personal, maximum improvement in facial scars may require more than one procedure, and more than one technique may be employed.

Understanding The Surgery

Re-excising the scar and reapproximating the edges of the deeper tissues as well as the skin with fine sutures will help improve a widened or irregular scar. Dermabrasion and laser resurfacing are methods a surgeon uses to make "rough or elevated" scars less prominent, by removing part of the upper layers of skin with an abrading tool or laser light. This works well for acne scars. Clearly, the scar will remain, but it will be smoother and less visible. Z-plasty is a method to move a scar from one area to another, usually into a natural fold or crease in the skin to minimize its visibility. While Z-plasty does not remove all signs of a scar, it does make it less noticeable.

Keloid or hypertropic scars are often treated first with injections of steroids to reduce size. If this is not satisfactory, the scars can be removed surgically, and the incisions closed with fine stitches, often resulting in less prominent scars.

When a scar is of the contracture type, surgery generally involves removing the scar tissue entirely. Skin flaps, composed of adjacent healthy skin, are then lifted and moved to form a new incision line. Where a flap is not possible, a skin graft may be used. A graft involves taking a section of skin tissue from one area and attaching it to another.

What To Expect After The Surgery

You can expect to feel some discomfort after surgery but this can usually be controlled with Tylenol. Some swelling, bruising and redness are generally unavoidable though minor. It is important for you to follow your after care recommendations to the letter. Though the sutures will be removed within days after the surgery, Dr. Majmundar would like you to avoid any activity that may place undue stress on the incision. It is important to remember that scar tissues require a year or more to fully heal and achieve maximum improved appearance. (TOP)