Everyone has different reasons for scars. It could happen through an accident or through a surgical procedure but whatever the case is it is always of a great concern because they are visible, don’t go away and forever deforms that part of your body.
Surgical Scar Reduction is a technique that can make the scar less obvious however it can completely remove the scar. There are also non-surgical techniques. Sometimes surgical and non-surgical techniques are used separately while sometimes they are combined to revise a scar.
While preparing for scar revision a surgeon usually decides which technique should be used on what type of scar in order to have good results. The assessment of scar depends upon its height, contour, color, and light reflection from scar, pliability, texture, vascularity and the scar relation to the lines of the skin.
An ideal scar is a scar which is cosmetically more suitable. The characteristics of an ideal scar are:
It should be a good and fine line.
It should be in line with the creases of skin
Its color and contour should match the surrounding skin.
It shouldn’t be in distortion with other structure or scar.
It should be in level with skin.
It should be in a fine position on the skin.
The non-ideal scar is the type of scar that needs scar revision and is clearly visible.
These type of scars are wide
They are dark and pigmented.
They are they are depressed or blistered or are not in sync with natural lines of face and junctions.
Scar revision doesn’t completely remove a scar but rather make it less obvious.
It is not specific when to do a scar revision. However one should wait until the scar is matured enough. It can happen in two to three months and even a year. The time for each scar is different.
There are two types of techniques. Surgical and Non-surgical.
Below are the various surgical scar revising techniques.
It is the most commonly used scar revision technique. With this technique, surgeons can redirect scar into a better position with the skin folds and the place where the skin tension is minimum. Short scars are lengthened with this technique if needed.
In this technique, two triangle flaps of equal size are created and then their position is changed with each other. The length of both flaps is the same which is the key to its good results. The angle and length of these two flaps are kept same in order to avoid mismatch and flaps that might prove too difficult to close.
The detachment of flap due to high tension on the wound.
This process involves the removal of skin in order to create a more acceptable scar. While performing the procedure it involves the same techniques as the Z-plasty which includes skin tension, anatomy, tissue movement, suturing technique.
This technique is commonly used to level and smooth the texture of a scarred surface and make it even with skin. It improves scar by grafts and flaps in order to blend it with the surrounding.
This procedure is usually performed through a diamond tip or a pressurized aluminum oxide crystal and is used on the scars that are inflated.
Large scars which cover an excessively large area are revised using flaps, tissue expansion, Integra artificial skin, flap and skin grafting.
This technique is used in the area where the surrounding tissues are difficult to mobilize.
There is a risk of hematoma formation.
Infection to the wound is possible like any other surgery.
There is a chance of hyperpigmentation, however, this condition entirely depends on patient avoidance of sunlight and sunscreen can prevent it.
There is also a chance of keloid formation.
Scar could become excessively wide.
If the stature of the wound is not good then it can cause tension in the wound
All of these complications could be prevented by performing the scar revision through a skilled surgeon.
Some of the non-surgical techniques of scar revision are following.
Camouflaging the scar can greatly help in making the scar less evident. This includes makeup, tattoos, and hair
Intralesional corticosteroids: These agents reduce the formation of scar however it doesn’t reduce the size of a scar but rather flatten it.
Intralesional 5-Fluorouracil: Also known as 5-FU give good results when combined with radiation, pulse dye laser or corticosteroids. It greatly improves the scar’s looks.
Other Intralesional agents: Agents like intralesional bleomycin, hyaluronidase or intralesional interferon are also used for scar revision.
Intralesional corticosteroids: These agents reduce the formation of scar however it doesn’t reduce the size of the scar but rather flatten it.
Cryotherapy is sometimes used alone while some time in combination with Intralesional agents or surgical procedure. Cryotherapy combined with the Intralesional agent can quickly destroy the scar in the deeper scale while the damage to the scar’s surface is kept to a minimum.
A non-ablative pulse dye laser is used to decrease the redness in the scar which is achieved by destroying the blood vessels in the scar. This treatment is to be started at the time of removal.
Synthetic fillers such as fat and hyaluronic acid etc. This is used to fill the depressed scars.
Yes, it definitely is! If you have a facial scar it could greatly demean and undermine your self-confidence but with scar revision technique can change that.
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