COSMETIC SURGERY
Scar revision
A scar, or cicatrix is a mark left in the skin by the healing of a wound, burn, or surgical incision in which normal skin tissue is either lost, resulting in a depressed scar, or replaced by elevated connective tissue in the form of a hypertrophic or keloid scar.
Some spots on the skin may not be true scars, as they will disappear over time, but may still be visible and a cause of embarrassment. Scar revision surgery cannot remove all evidence of a scar but it can reduce and blend the scar into surrounding skin. Though all surgeons close wounds, the special expertise of a plastic surgeon can improve healing and reduce scaring when a wound is large, jagged or cannot be covered with the skin currently at the site. Regardless of whether the scars were caused by injury or previous operations, scar revision surgery can be used to remove keloid scars, hypertrophic scars, contractures and facial scars.
Keloid scars
This is a special type of scar that overgrows the original wound, looking like exaggerated scars, raised above the skin around them and sometimes domed. They are shiny and hairless with a hard and rubbery texture, initially often red or purple but becoming browner and sometimes paler as they age. Surgery involves cutting out the material, normally made of hard fibrous collagen, and then the skin is sewn back together. After the procedure it is very important to monitor the scar for signs of keloid recurrence as preventative measures can be instituted.
Hypertrophic scars
Often confused with keloid scars, hypertrophic scars are thick red and protrusive. But, unlike keloid scars that grow outside the initial incision area, hypertrophic scars remain within the original incision boundary. A surgeon will remove this excess scar tissue, and may re-position the original incision line, so it heals in a less-visible fashion.
Contractures
Loss of substantial skin areas through burns or other injuries results in scar tissue pulling together outlying skin areas, sometimes restricting muscle movement. Scar revision can help release that 'pull' by replacing the scar tissue with a skin graft.
Facial scars
Although these cannot be completely removed, surgery to re-position a scar to match with natural facial contours and lines can make the scar less visible. This involves a scar revision technique known as z-plasty whereby scar tissue is removed, and then the skin is cut to create triangular flaps at both ends which are then laid across the original scar area at angles, often creating a 'z' shape. The flaps are then sewn over the area, reducing the visual impact of the original scar.