Dr. Mike Majmundar, double board certified facial plastic and reconstructive surgeon, performs facial scar revision for the residents of Atlanta, Sandy Springs and the surrounding communities in Georgia.
Surgery of Facial Scars
With very few exceptions, most people are self-conscious about facial scars. When the skin recovers from an injury due to an accident, surgery, a burn or acne, scarring occurs wherever multiple layers of the skin have been affected.
Some people may also experience diminished functioning of the eyes, mouth or nose. Once a scar forms, it is permanent; however, it may be made less visible or relocated surgically to improve your appearance, self-confidence or level of facial functioning.
Making the Decision for Facial Scar Treatment
Different scars require different treatments. Keloid scars result from the skin’s overproduction of collagen after a wound has healed. 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 during the initial consultation, along with the risks involved for each type of scarring. The agreement between you and Dr. Majmundar on how to proceed is a prerequisite for successful surgery. Once it is decided to proceed, 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 technique.
Understanding the Surgery
Re-excising the scar and re-approximating 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. This works well for acne scars. 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 hypertrophic scars are often treated first with injections of steroids to reduce the size. If this is not satisfactory, the scars can be surgically removed 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 to follow your after care recommendations. The sutures will be removed within days after the surgery; however, 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.
Surgery: In-Office or Outpatient
Anesthesia: General or IV sedation, Local
Procedure Length: Depends on the size and type of scar, but usually 30-60 minutes
Recovery: On average, 0 (smaller scars) – 7 days (larger scars).