Scar Revision

We understand that scars can be very upsetting for an individual and difficult to look at each day in the mirror. Although a scar can never be completely removed, most scars can be significantly improved.  The goal is to make the scar no longer noticeable. Depending on the size, shape, and location of the scar, various techniques are used for revision. Surgical excision, dermabrasion, or the injection of medication or dermal fillers will typically be used to achieve an improvement in the appearance in the scar.

What is a scar?

Scars are a natural part of the body’s healing process. Most wounds, except for very superficial ones like scrapes or scratches, result in some degree of scarring.

When the dermis (deep, thick layer of skin) is damaged or missing, the body immediately kicks into healing mode.  The surrounding tissues and blood vessels begin to fill in the missing skin with collagen.  The collagen that is deposited does the job of filling in the missing skin, but it has a different texture and quality than the surrounding tissue. 

What are hypertrophic and keloid scars?

Sometimes the scarring process can behave in an unnatural way resulting in a hypertrophic or keloid scar.  Although this can happen for no apparent reason, it is more commonly associated with negative wound healing factors, such as infection, excessive tension, foreign bodies, and repetitive trauma. 

Hypertrophic and keloid scars tend to be raised, larger, and thicker than traditional scars.  This is a result of excess collagen production, different types of collagen in the scar, and a more disorganized arrangement of the collagen fibers. 

Hypertrophic scars do not extend beyond the boundary of the original wound, whereas Keloid scars tend to grow beyond the boundaries of the original wound.  Both types of scars eventually reach a certain size where they will stabilize or regress, but they will not go away without treatment.  

What are “Sunken in” scars?

Some scars can have a sunken or pitted appearance. This kind of scarring occurs when underlying structures supporting the skin (for example, fat or muscle) are lost. Some surgical scars have this appearance, as do some scars from acne.

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