Plastic surgeons who are honest and forthcoming will never “guarantee” surgical results. They’ll forecast or suggest what you might look like, show you before and after pictures so you generally know what to expect and work hard to understand your wishes and translate them into reality. They’ll also tell you that each person is unique, and so is each procedure and post-op period. In short, healing is unpredictable—and that goes for scarring as well.
Even if you’ve done basic research on scars and taken every precaution, you still might end up with an unattractive, tell tale mark of plastic surgery. If this happens, what are your scar revision options?
In short, the approach to improve the look—and in some cases, the function—of a scarred area depends on the scar. For minor scars and to aid in healing after scar revision surgery, you might try medical tape, compression or a gel. To reduce superficial scarring and uneven pigmentation, surface treatments are often a good choice. These can include dermabrasion, laser or light therapy and chemical peels (ASPS 1).
For depressed scars, the best treatment is often an injectable substance such as a dermal filler. Results are temporary and treatment will eventually need to be repeated (ASPS 1).
Two kinds of troublesome scars that can result from plastic surgery are hypertrophic scars and keloid scars, or scars that become prominent due to an overproduction of collagen during healing. Both kinds tend to be more prevalent in young people and in people with darker skin tone. There can also be a family tendency toward this kind of scarring, meaning once you’ve had a hypertrophic or keloid scar you may experience another (Smith & Nephew 1).
Hypertrophic scars are red or dark in color and are raised above the skin’s surface, but do not otherwise spill over beyond the boundaries of the wound. They may be itchy and/or painful, and in some cases may restrict movement. Keloid scars grow beyond the boundaries of the surgical site, and they’re most common on the ears, chest, shoulders and back (Smith & Nephew 1). They can resemble shiny domes or tumors—you can see examples here: http://www.yourfaceinourhands.com/photo-gallery/results.cfm?Category=15.
Plastic surgeons and dermatologists will often start treating hypertrophic and keloid scars with steroid injections (Smith & Nephew 2). If injections don’t work, surgery can be tried, and some plastic surgeons prefer a surgical approach for these kinds of scars (Mabrie 1). Because keloid and hypertropic scars have a tendency to return (Smith & Nephew 2), it’s important to seek treatment from a very experienced physician.
Surgery is an option for a variety of scars, including but not limited to keloid and hypertrophic scars. Severe scars sometimes require a procedure known as a Z-plasty, in which many small incisions are created around the existing scar, and the skin is sutured back together to release constriction and improve the look of the area (U.S. National Library of Medicine 1). This technique is sometimes used for plastic surgery scars that did not heal properly, but more frequently for burn scars and scars from injuries.
Scars cannot be completely removed, and it’s important to set your expectations accordingly. But you can improve your odds by visiting a plastic surgeon or dermatologist with vast experience in treating scars and many tools at the ready.
References:
American Society of Plastic Surgeons. Scar Revision, minimize a scar: What happens during scar revision surgery? Thousands of Member Surgeons, One High Standard. Web. May 30, 2011.
http://www.plasticsurgery.org/reconstructive-procedures/scar-revision.html?sub=What%20happens%20during%20scar%20revision%20surgery?
Smith & Nephew. Scar therapies. Smith & Nephew Wound Management Site. Web. May 30, 2011. http://www.scarinfo.org/scar_facts.html
Smith & Nephew. Scar facts. Smith & Nephew Wound Management Site. Web. May 30, 2011. http://www.scarinfo.org/therapies.html
Mabrie, David. Keloid Correction Surgery. Your Face in our Hands. Web. May 30, 2011. http://www.yourfaceinourhands.com/plastic-surgery/keloid-correction.cfm
U.S. National Library of Medicine, NIH, National Institutes of Health. Scar revision. MedlinePlus. Web. May 30, 2011.
http://www.nlm.nih.gov/medlineplus/ency/article/002991.htm
Reviewed June 10, 2011
Edited by Alison Stanton