Posts Tagged scar surgery
Scar revision is a type of surgery to improve scars. Advertising makes the treatment of scars very confusing. There are thousands of products with packaging promising anything and everything. Most people with disfiguring scars know most of these products offer little help.
Some scars can be improved with surgery however: scar revision surgery. Here’s an example of a scar revision case from my Orange County Practice:
Scar revision does not help all scars but rather scars that are wide or pigmented. In small cases, the surgery can be done in the office under local anesthesia only (numbing shots.) This brings the cost down. This doesn’t make it cheap, but makes it less expensive. Lasers are usually not used in scar revision surgery as they are not of proven benefit. Lasers do increase the cost however.
John Di Saia MD
Originally posted 2011-11-18 07:30:42.
I have a wide scar on my leg that I got years ago. I have tried creams and stuff. When is surgery a good idea to improve a scar? Can a cream or a laser make it thinner?
Scar improvement has several phases and the condition of your body and how the wound occurred have parts to play. Early on after wounding there is the question of whether or not to have surgery to repair the wound. If the edges are clean and close together, then surgery is not always beneficial. If they are apart or the wound is dirty a proper medical evaluation and/or surgery can make things better down the line. When in doubt, get that evaluation.
Once the wound has started healing, if the edges are were not put together or were traumatized then scar tissue will form along those areas. Scar tissue doesn’t look like regular tissue. It doesn’t tan like regular tissue and it can be lumpy or obvious.
Surgery can improve a scar at this stage, but that scar should be allowed to mature before surgery is performed in most cases. The tissue softens and this makes the results of scar revision surgery potentially better.
In your case if a year has elapsed I would say have a good plastic surgeon look at your scar to give you an opinion on the potential for improvement. Many small scar revision procedures can be done under local (numbing only) shots in the office to keep the cost down.
John Di Saia MD
Originally posted 2010-06-16 07:30:09.
Is there anything to do for white pigmented scars post surgery, do they usually resolve themselves? Is cortisone cream helpful? Also a small strip of skin going down from incision has turned whiter, perhaps from tension?
You have several issues here:
(1) Pigment – The color of scar tissue and normal skin is different. Trauma and bleeding in the tissues can also introduce color changes. The lack of pigment is a white color which is probably scar (if you are Caucasian.) If this area is wide you might be a candidate for a scar revision.
(2) Timing / Non Operative Care- Scars do improve over the first year or so after the wounding that caused them to form. They do so better if kept out of the sun or if sun screens are applied. Silicone sheeting and/or massage can be helpful as well as the scar matures or remodels.
(3) Tension – Tension usually does not cause long term color changes in a scar unless there is quite a bit of it.
(4) Steroids – Steroid creams are not always helpful. I would avoid them unless professional advice recommends their use.
It sounds like you need an evaluation to figure your next best move.
John Di Saia MD
“I had been consulting with many local plastic surgeons to revise a wide, dented scar that I had on my leg. One doctor suggested tissue expanders but the price was ten thousand dollars which was too much for me, so then I consulted with another doctor which convinced me to have Restylane injected in my scar to improve the dent but that still made no difference. I continued to consult with other doctors that gave me no hope because they would tell me that my scar was too wide for revision.
I was ready to give up when I found my Dr’s web page and saw he had revised a scar similar to mine. I am really glad that I went to him. I will always be so thankful to him since he was the one that was able to improve the appearance of my scar after the scar excision, now my scar is as thin as a pencil line and there is no more dent and it is already fading away. He is the best of the best.”
Wow. Here’s a nice review of a scar revision operation I did for a patient on Real Self. How kind. Restylane really does very little for depressed scars. Wide scars are best addressed by revision in my opinion.
John Di Saia MD