What is Scar revision?
A scar is an area of fibrous tissue that replace normal skin after an injury or excision. It is the normal way in which tissues heal in the skin. There are very few types of tissue trauma that dont cause scars. The ideal scar is a flat thin line that blends with the other injured tissue. There are two types of scars, they are the underhealing scar or overhealing scar (hypertrophic and keloid scars). The underhealing scar is shallow, weak and prone to wound breakdown. This may be related to the poor wound healing state of the patient or the area. It can sometimes be seen in infection. The overhealing scar or hypertrophic or keloid scar results from the body overproducing collagen, which causes the scar to be raised above the surrounding tissue. It can be unsightly, lumpy, stretched, or prominent. There are some things that can explain why some people may have underhealing or overhealing scar. For example, it the wound has been slow to heal, in the area of the upper back chest or shoulders, if there is tension on the wound or in darker skin people, there is a higher propensity to form a keloid scar.
Scar Revision is a surgical procedure to modify the scar by narrowing the original scar or simply reorganise the scar to match the natural skin creases. However, not all scars require surgical intervention. It is common practice for Plastic Surgeons to suggest non-invasive options such as steroid injections, use of silicone gel and natural remedies before considering surgery as the last resort. After scar revision surgery, it is important to avoid sun exposure for 3 – 6 months after the surgery.
The Surgery
The precise procedure varies with each patient depending on the proportions of body type and the desired surgical outcome. A Scar Revision is a day procedure performed under Sedation at Darwin Day Surgery. The surgery can take between 30 minutes to 1 hour. Patients are advised against engaging in strenuous activities such as heavy lifting and sports for several months. Most patients are able to return to work within 1 – 2 weeks post-operatively. Some larger scars may need admission to hospital.
Silicone Gel or sheeting
Silicone gel or sheeting is a useful, convenient and economical treatment for raised scars. These modalities help to flatten the scars after a procedure for scar revision or if a post-surgical scar starts to thicken. It is usually supervised with the aid of an occupational therapist who will help you with scar management and massage
Steroid Injections
Thickened scars may sometimes need local steroid injections to help treat the scar in an attempt to flatten the scar. It may require 3 injections at 2-month intervals, alone or in conjunction with other scar management therapies. The injections can be painful so are performed under local anesthetic or under sedation. The effect is not always predictable. Sometimes it may not work or work too well and side effects can include, weaker skin, pigment change in the skin, loss of fat underneath the scar called fat atrophy.
