Other Surgery

Scar Revision & Scar Surgery

 

Scar revision or scar improvement with surgery is usually a last resort after other modalities of treatment have been tried. Scars can be unsightly or abnormal because they are stretched (wide), red, lumpy, hypertrophic or keloid. Patients may also seek treatment because the scars are tight or restrict joint movements or other functions. Scars may also be in orientated in an unfavourable direction thus making them prominent. Hypertrophic scars are lumpy, firm, red, raised and itchy. Keloid scars or keloids are similar but, by definition, are bigger than the original injury which caused them and are more common in darker skinned individuals. Certain sites in the body have a higher risk of forming “bad” scars: the central chest area, the shoulder (deltoid) area, ears, etc.

Professor Malata offers a range of procedures to improve scars including steroid injections, silicone gel cream, silicone gel sheets, pressure garments, occlusive tape, intralesional excision and steroid injection, pressure therapy, etc.. The scars may also be excised and resutured neatly and more accurately. Another common surgical treatment is to realign the scars in the form of a z-plasty, W-plasty, V-to-Y advancement and other flap technics. The colour of some scars can be improved by camouflage tattooing or laser treatment. Professional and amateur tattoos are also sometimes amenable to surgical improvement. Keloids which are resistant to treatment can be referred for radiotherapy but usually not in patients younger than 50 years of age.

Professor Malata will discuss with you in details what procedure is most appropriate for you or whether you need referral to the laser centre, the cosmetic camouflage service or rarely the radiotherapists.

The length of surgery, anaesthesia required, and the specific recovery vary greatly depending on the type of scar revision undertaken. Professor Malata will discuss with you precisely what you need.

 

Some risks of scar revision

  • Bleeding and haematoma: uncommon

  • Infection: rare

  • Delayed healing and wound breakdown

  • RECURRENCE OF THE SCAR – very common

  • Numbness

 

Alternatives to scar revision surgery

  • Accept the scars

  • Conservative treatment

  • Camouflage cosmetics

  • Laser: for redness

  • Radiotherapy: as a last resort for recurrent keloids