Violation of the skin through the deep dermal layer inevitably results in scar formation. Scars are the mark of healed tissue that has recovered from injury. Once a scar forms, it is permanent but may be made less visible by optimization strategies including camouflage, excision, dermabrasion, grafting and surgical relocation.
A scar can never be fully erased but the goal of intervention is to improve the appearance of the scar either by camouflaging it, relocating it, or minimizing its prominence. Skin color and type, age, and the type of scarring, are all important variables that go into the process of evaluation and decisions for treatment. It is important to remember that scar tissues require a year or more to fully heal and achieve maximum improved appearance.
Scar Revision In Depth
by Monica Tadros, M.D., F.A.C.S.
Is Facial Scar Treatment For You?
With very few exceptions most people are self-conscious about facial scars. Some facial scars are unattractive simply because of where they appear on the face, while others affect facial expressions. Facial plastic surgery makes it possible to correct facial flaws that can undermine self-confidence. Changing how your scar looks can help change how you feel about yourself. Different types of scars and deformities may require different or multiple techniques to camouflage their appearance. Some people may also experience diminished functioning of the eyes, mouth, or nose due to scarring and contracture in the area of a healed wound. The functional versus cosmetic nature and the need for scar revision surgery depends on the pathology, appearance of the defect, psychological impact and compromise of function associated with the condition. Insurance does not generally cover surgery that is purely for cosmetic reasons; however, surgery to correct or improve scars caused by injury may be reimbursable in whole or in part.
Excellent candidates for scar revision surgery have realistic expectations and motivations for seeking intervention.
Severe burns that destroy large areas of skin and/or soft tissue may heal with tissue atrophy (a depressed area) or scar contractures. ‘Contractures’ of the skin healing over muscles and tendons result in a puckered defect with compromise of movement in the area of scar.
Keloids and hypertrophic scars are the result of an over-production of collagen during healing, resulting in a prominent, unattractive scar. Keloids are benign growths that grow beyond the boundaries of the scar area and represent a medical condition. Hypertrophic scars remain contained within the boundaries of the scar area, but because of their thickened, raised nature may also restrict the movement of underlying tissues, similar to contractures.