Scar revision surgery

What is a scar?

Scars are a natural part of the healing process after surgery or injury. Most scars fade over time, but some can remain noticeable or cause discomfort. A scar can take 12 to 18 months to fully mature.

What are the common problems with scars?

Scars can cause problems in different ways:

Hypertrophic scars: These are thick and raised scars. They may be darker or lighter than your normal skin.
Keloid scars: These are larger than hypertrophic scars and spread beyond the original wound. They’re often itchy and may be more common on the ears, chest, or shoulders.
Contractures: These scars can pull the skin tight and limit movement, especially if they are over joints or from serious injuries like burns.
Cosmetic concerns: Some people feel self-conscious about the appearance of their scars, especially if they are on visible areas of the body.

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What does scar reconstruction involve?

Scar reconstruction aims to improve the appearance or function of a scar. Dr Law will assess the best course of action for treating your scar based on the history of the scar, the scar type you have, how the scar is affecting your function, movement, and how much it bothers you cosmetically. This will be considered in the context of your general health as well as your goals and expectations.

Treatment options

There are several ways to treat scars, depending on their type, location, and how they affect you. Scar management includes both non-surgical and surgical options, and these are often used in combination to achieve the best possible result.

Non-surgical options include:

Gels, silicone tapes, and compression garments.
Laser treatments, dermabrasion, or intense pulsed light therapy.
Radiotherapy.

Surgical options:

Scar revision surgery to remove or reshape the scar.
Tissue rearrangement using nearby or distant skin.
Skin grafts with or without artificial skin substitutes for large scars.
Tissue expansion to stretch healthy skin and cover scarred areas.

What’s best for you?

The best treatment depends on your unique situation. Dr Law will discuss your options and recommend the most suitable plan during your consultation.

Procedure information

You may be a good candidate for scar revision surgery if:
- You are in good health.
- Have realistic expectations about what surgery can achieve, and understand that there is a risk of scar recurrence.
- You are able to comply with scar therapy after surgery.
- Small scars can be revised in our office with you awake. Surgery on larger scars are performed in the operating room as a day case.
- Surgery involves cutting out the scar that is causing you problems. The pattern in which Dr Law cuts out your scar may be a straight line or a zig-zag line.
- The scar reconstruction will vary depending on your unique circumstances.
- In some cases, a steroid medication will be injected into the incision at the time of surgery.
You will be given instructions on your individual aftercare based on the size, type, and location of your scar.

Risks & complications

All surgery carries risks and may include:
- Drug reactions: You can have reactions to anaesthesia. However a fully qualified anaesthetist will speak to you before surgery to ensure your anaesthetic will be as safe and smooth as possible.
- Allergic reactions: Allergic reactions to materials such as sutures, dressings, or antiseptic solutions are possible. We will ask you about any known allergies beforehand to help avoid exposure during surgery.
- Infection: You will be given antibiotics at the start of your surgery (as you go to sleep), as well as a course of oral antibiotics afterwards, to help minimise this risk.
The main risks of scar revision surgery include recurrence of poor scarring and wound healing problems.
People who have developed problematic scars in the past may be at higher risk of similar outcomes after surgery. For this reason, scar revision is often combined with additional scar management techniques such as massage, silicone therapy, pressure therapy, steroid injections, and in very severe cases - radiation therapy. Regular follow-up is essential in monitoring your progress and adjusting treatment if needed. It's also crucial to be consistent with scar therapy, as this can be just as important as the surgery itself in achieving the best long-term result.