Scar Revision

Any time skin is cut through its entire thickness, a scar will form. Unfortunately, all scars are permanent in that they cannot ever be erased. We can, however, manipulate them to optimize function and appearance.

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In general, every scar goes through what is called a maturation process. In adults, a scar takes about one year to mature fully. One can expect a surgical scar to look its worst approximately six weeks to three months following the surgery. During the most active healing period, the body forms collagen to heal the initial wound. Unless there is a fundamental problem with the scar, such as the need to alter its direction or remove unhealthy tissue, it is generally best not to consider revision in less than one year, when it can be regarded as mature.

Sometimes, a scar remains unsightly even after it’s fully healed. This may be especially bothersome to the individual if the scarring is located on the face or another conspicuous part of the body.

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There are several factors to consider when determining if a patient is a candidate for scar revision surgery. To assess whether a scar is appropriate for revision, Dr. Rapaport thoroughly evaluates the size and depth of the wound, the blood supply to the area, the thickness and color of the skin, the direction of the scar, the tension on the wound, and the way the patient’s body heals (based on the examination). During the consultation, Dr. Rapaport will discuss these factors to determine the best treatment option for each patient.

In adults, scars generally take one full year to mature. Therefore, scar revision surgery is usually recommended for scars one year or more in age. In children, scars frequently take as long as two years to mature. Therefore, it is typically appropriate to wait longer before revising scars on children. We must also consider the child’s growth stage when properly strategizing the timing of scar revision. It may be appropriate to wait until after a growth spurt before revising a child’s scar, which will be subjected to the tension of that growth spurt.

Scar revision may involve various surgical and non-surgical techniques, including local skin rearrangement, skin grafting, and laser therapies, used to alter the appearance of a scar to improve the appearance and function of the area involved.

Surgical scar revision generally refers to the excision of an existing scar followed by reconstruction of the wound through reapproximation of the tissue, possibly with flap reconstruction or Z-plasty (a type of skin manipulation performed to alter the direction of a scar). Scar removal surgery may be employed to improve keloid scars, acne scars, burn scars, hypertrophic scars, depressed or retracted scars, facial scars, and scars caused by injury or previous operations.

Unfavorable scars from surgery are avoidable if the surgeon makes the incision expertly and closes the wound with the lowest amount of tension possible. A prime example of this is an abdominoplasty (tummy tuck) scar. The key to optimal tummy tuck incision is placing it in the right location (as low as possible) and closing it in layers so the skin is under the least amount of tension possible. Achieving this goal requires that the entire procedure be performed in a skilled manner. With over 25 years of experience in scar revision, Dr. Rapaport’s surgical expertise will ensure that your scar is closed in the most expert way possible.

During a detailed consultation, Dr. Rapaport or a team member will determine the best treatment for your scar. We offer both surgical and non-surgical solutions, and some patients may require more than one modality for optimal scar removal. 

Non-surgical scar treatments include:

  • Laser treatment
  • Steroid injections
  • Superficial scar filling
  • Silicone therapy

Lasers may be used to reduce the pink coloring of a scar or can act like microdermabrasion to essentially sand down the rough edges of an acne scar. Steroid injections and silicone therapy may be beneficial to help the scar heal on its own, while scar filling may improve the appearance of depressed scars.

In some cases, surgical scar removal may be needed. Scar revision surgery is typically a minor procedure performed under local anesthesia. More extensive scars may sometimes require IV sedation or general anesthesia. Our team will give you details about your personalized procedure during your consultation.

Since there are multiple scar removal options, recovery and side effects vary. It is typically a very localized treatment with minimal impact. Non-surgical scar treatments may cause redness, swelling, or bruising in the treated area for a few days but don’t require downtime. Surgical scar removal may involve a few days of downtime, especially for large scars.

During recovery both from the original injury and the scar revision procedure, proper care of the area is essential to minimize future scarring. Patients must keep incisions or wounds clean and moisturized. In the following weeks and months, you can encourage ideal healing with silicone sheets or gels and by strictly protecting the scarred area from sun damage.

Scar revision results depend on the treatment method, the patient’s aftercare, and their unique healing. Some treatments may lighten a dark or reddish scar, others help smooth and flatten a raised scar, and others fill in depressed scars. These results may not be immediate and may require more than one treatment session. With proper aftercare, patients can expect significant and long-lasting improvement. 

Keep in mind that scars can never be fully erased. In some cases, only mild improvement may be possible, while others may achieve dramatic results. Based on your consultation and personalized treatment plan, we will discuss what results you can expect.

Take the Next Step

Every patient’s transformation journey at Rapaport Plastic Surgery begins with a detailed consultation with Dr. Rapaport. To learn more about scar revision and determine if it’s the right choice for you, fill out the form below or call us at (212) 249-9955 to schedule an appointment. Our team is dedicated to providing the best plastic surgery NYC has to offer.

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