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Scar Revision & Repair
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Laser Scar Revision & Repair
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Description

Scar revision is the name given to a range of surgical techniques used to alter the appearance of scar tissue, blending it in with the surrounding skin area to improve the appearance of the scarred area


Length of Surgery

1 – 5 hours


In/Outpatient

Outpatient


Anesthesia

Local and/or sedation, or general anesthesia, depending on the extent of the area to be treated


Back to work in...

3 – 7 days


Back to the gym in...

2 weeks


Treatment Frequency

Usually once, unless the scar recurs or a keloid forms or recurs


Risks

Bleeding; infection; allergic reaction to the anesthetic; blood clots; the scar may grow, change color, or otherwise become more noticeable; numbness; recurrence of scar; keloid formation (or recurrence); separation of the wound; arkening of the new scar due to sun exposure


Duration of results

Permanent



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Scar revision Surgery Costs*

Scar revision surgery prices vary, depending on the procedure, the techniques used, and the extent of the area to be treated. The American Society of Plastic Surgeons quoted the national average for Scar revision is approximately $500. Talk to your scar revision doctor to obtain a more exact estimate of the price.

The total scar revision surgery cost will comprise three fees: the anesthesia fee, the facility fee, and the surgeon's fee. The surgeon's fee is the majority of the cost, and the most difficult to predict without first knowing the extent of the procedure and the qualifications of the scar revision surgeon. Surgeons with the most expertise cost more, but for this kind of complex, highly visible cosmetic surgery (especially for facial scars), it is advisable to use a very experienced scar revision surgeon.

Most cosmetic surgeons and surgical clinics offer flexible scar revision financing and payment options, some of which allow staggered payments or loans from VARIOUS FINANCING COMPANIES.

If you are considering having scar revision surgery but want to explore more about the financing options available before you make your decision, PLEASE CLICK HERE. You can discuss your financial options with your surgeon, and find out if there are any loans of flexi-payment plans that will allow you to achieve the appearance you have always desired.

Am I a candidate for a scar revision surgery?

Scar revision can be performed on people of any age. If any of the following apply to you, you may be an ideal candidate for scar revision:

  1. You have any type of scar (as described above) on any part of the body that bothers you, impairs function, or limits movement of any of your joints
  2. You have a scar that has been caused by trauma or did not heal perfectly at the first operation
  3. You are physically and emotionally in good health
You may not be a good candidate for scar revision if you have:
  1. Active acne or other skin diseases in the area to be treated
  2. Flatter, more widespread scars - these can sometimes be improved with resurfacing techniques such as laser skin resurfacing.
  3. You are a heavy smoker
  4. You have a family history of keloids
  5. You have any other disorder or condition that may affect the healing of scar tissue, including diabetes, lupus, scleroderma, and other auto-immune disorders
Good candidates for scar revision surgery also have a realistic understanding of the scar revision surgery’s risks and benefits, and realistic expectations of its potential outcomes. You must also be choosing to undergo the scar revision procedure for yourself, not to please anyone else.

 

What is a scar revision Procedure?

Scar revision is the name given to a range of surgical techniques used to alter the appearance of scar tissue, blending it in with the surrounding skin area to improve the appearance of the scarred area. Although scar revision cannot completely remove evidence of a scar, it can be used to remove keloid scars, hypertrophic scars, contractures and facial scars, whether the scars were caused by injury, wounds, or previous surgeries.

Scars, whether they're caused by accidents or by surgery- are unpredictable. The way a scar develops depends as much on how your body heals as it does on the original injury or on the surgeon's skills. Many things can affect the severity of scarring, including the size and depth of the wound, the blood supply to the area, the thickness and color of your skin, and the direction of the scar. Scars can have a detrimental effect on the wellbeing of a person, and while no scar can be completely removed, cosmetic surgeons can often improve the appearance of a scar, making it less obvious through using a group of surgical procedures known as scar revisions.

Scar revision is a technique that can be used on scar tissue anywhere on the body, and it produces permanent results. People typically elect to have this surgery where scar tissue is highly visible, such as on the face, hands or forearms.

Problem scars may result from trauma including cuts and burns; previous surgery; inflammatory diseases such as acne or a genetic predisposition for skin to overreact to injury. Tension on the skin around the wound, foreign material in the wound, infection, or anything that delays closure of the wound may also contribute to scar formation.

There are four types of scar that may benefit from scar revision surgery, all of which are likely to have developed when the natural repair process was interrupted or disturbed:

  1. Keloid scars – Thick, puckered and itchy dark red scar tissue, normally formed of hard fibrous collagen, that grows beyond the boundaries of an incision while healing from a previous surgery. This type of scar can be removed by scar revision where the scar revision surgeon cuts out(excises) the material, then sews the skin back together. This is generally a day case performed under local anaesthesia. You should be back at work in a day or two, and the stitches will be removed in a few days. Keloid scars can recur, so it is very important to monitor the scar for signs of keloid recurrence.
  2. Hypertrophic scars – Similar in appearance to keloid scars, hypertrophic scars protrude and are thick and red. Hypertrophic scars remain within the original incision boundary, unlike keloid scars. The scar revision surgeon removes this excess scar tissue, and may reposition the original incision line so that it heals more unobtrusively. This surgery may be done under local or general anaesthesia, depending on the scar's location and what you and your surgeon decide is the best course of action.
  3. Contractures – These scars result after a large amount of skin has been injured, for example as the result of a burn. The scar tissue pulls together outlying skin areas, sometimes restricting muscle movement. Scar revision can help to release the ‘pull’ by replacing the scar tissue with a skin graft.
  4. Facial scars – Although facial scars cannot be completely removed, it is possible for a surgeon to re-position a scar to blend with the rest of the facial contours, making the scar less visible. To do this a surgeon will use a scar revision technique known as z-plasty. This technique involves removing the scar tissue and then cutting the skin to create triangular flaps at both ends. The flaps of skin are then laid across the original scar area at angles, creating a ‘z’ shape. The flaps are then sewn over the area, reducing the obvious appearance of the original scar.
Scar revision may take one to three hours to complete, depending on the techniques used and the extent of the areas to be treated. Smaller scars and areas can be treated under local anesthetic, but larger scars or those in very sensitive areas may require general anesthetic. Many patients are able to go home on the day of the surgery but some remain in the hospital for one or two days after scar revision surgery.

Scar revision recovery time is largely dependent upon the amount of work required, and also on the position of the scar. It may take anything between three days and two weeks to return to normal activities.

If you're bothered by a scar, your first step should be to consult a board-certified scar revision cosmetic surgeon. Though you may be concerned about a scar that has recently formed, many scars that appear large and unattractive at first may become less noticeable with time. Some can be treated with steroids to relieve symptoms such as tenderness and itching. Many cosmetic surgeons will recommend waiting as long as a year or more after an injury or surgery before you decide to have scar revision, to be sure that the scar revision surgery really is necessary.

Before you choose to undergo a scar revision operation, you will need to discuss the pros and cons of the surgery with your scar revision surgeon to make sure you fully understand the scar revision operation, the possible side effects, risks, complications and recovery times of the treatment he recommends for your specific scarring.

The scar revision surgeon will examine you, take a full medical history, ask you about any medications or herbal supplements that you are taking, and discuss the possible methods of treating your scar, the risks and benefits involved and the possible outcomes. Be honest in discussing your expectations with the surgeon, and go prepared with a list of questions to ask and express any concerns you may have.

Your expectations for the outcome of your scar revision procedure need to be realistic. Your scar may look worse at first but this is only natural and the final results of your surgery may not be apparent for a year or more. Keep in mind that no scar can be removed completely and the improvement depends on the size and direction of your scar, the nature of your skin, and how well you care for the wound after the operation.

Medical insurance does not normally cover cosmetic procedures. However, if scar revision is performed to minimize scarring from an injury or to improve your ability to function, it may be partially covered. Check your policy or call your carrier to determine if you are eligible to claim.

 

Scar revision Surgery Procedure Steps

Depending on the type of scar, different surgical techniques are used for scar revisions. The following is an overview of the surgical procedures used for scar revision surgery, though individual practice may vary.

Step 1 – Anesthesia

  1. Medications will be administered for your comfort prior to the scar revision procedure. Then depending on the extent of the area to be treated, local anesthesia (which will numb the area to be treated) alone or in conjunction with sedation, or general anesthesia (which will put you to sleep for the entire scar revision operation) will be administered.
Step 2 – The scar revision procedure

Depending on the type of scar and the areas being treated, the scar revision surgeon will employ one of these techniques:
  1. Removal of keloid tissue – the scar revision surgeon removes the hard keloid scar tissue with a scalpel and a skin graft may be used to cover the area. The skin graft is performed by taking a piece of healthy skin from another part of the body (the donor site) and attaching it to the damaged area that is being operated on.
  2. Skin flap surgery - skin, along with the underlying fat, blood vessels, and sometimes the muscle, is excised by scalpel from a healthy part of the body and placed on the injured area
  3. Z - Plasty - a scar revision technique used to treat contractures and facial scars. The scar tissue is cut away (excised), then the skin is cut to create triangular flaps at both ends. The flaps of skin are then laid across the original scar area at angles, creating a ‘z’ shape. The flaps are then sewn over the area, reducing the obvious appearance of the original scar. Z - Plasty is used to decrease the skin 'pull' of a contracture. This technique can also be used to try and blend the scar in the natural creases and folds of the surrounding skin, for example for facial scars.
Step 3 – The sutures
  1. Once the old scar has been excised and reconstructed, it is re-sutured with either dissolvable or normal sutures. Sutures are usually removed in four to six days from the face and seven to 10 days from other parts of the body, though dissolving sutures are frequently used on the trunk and limbs to avoid stitch marks.
Step 4 – The results
  1. Once your scar revision surgery is finished, bandages or dressings may be applied to keep the surgical site clean. The final results of your scar revision procedure will take a long time to become finally apparent.

 

Scar revision Surgery Recovery and Healing Steps 

After your scar revision surgery, you will normally be sent home the same day. Arrange for someone to drive you home, and stay for a couple of days if possible to help you out.

A pressure or elastic dressing may be placed over the area after the scar revision operation to prevent the keloid scar from returning. For other types of scar revision, a light dressing will be applied. You may experience some localized swelling, discoloration or discomfort. Your doctor may prescribe some pain medication if you are in pain.

Initial wound healing after your scar revision operation may take one to two weeks. Further healing will continue for several weeks and as the new scar heals it will gradually refine and fade. You should be able to resume your daily activities within a week or so. Your scar revision doctor will probably recommend that you avoid activities that stretch and may widen the new scar, and will advise you about when to gradually resume your day to day activities.

The stitches will be removed three to four days after your scar revision surgery for the facial area, and in five to seven days for incisions on other parts of the body.

During the scar revision surgery recovery time, careful attention to your skin care regime and religious use of sun protection are essential to encourage healing. Sunlight can cause burns, permanent redness, loss of pigment in the skin, and breakdown of the collagen that maintains the elasticity of the skin.

The final results of your scar revision surgery will take a very long time to become completely apparent. No scar can be removed completely - improvement depends on the size and direction of your scar, the nature and quality of your skin, and how well you care for the wound after the operation. Your scar may look worse at first, but don’t worry, it may take up to a year or more to see the final results.

Scar revision surgery Side Effects and Surgery Risks

When a scar revision procedure is performed by a qualified and experienced scar revision cosmetic surgeon, complications are infrequent and usually minor. Scar revisions are commonly performed and generally safe. The possibility of scar revision risks and complications arising depends on each patient‘s anatomy, their physical reactions, and their healing abilities. As with any surgery, the outcome is not predictable.

Side effects are inevitable with any surgical procedure, and scar revision surgery side effects may include:

  1. Swelling
  2. Bruising
  3. Discoloration
Scar revision surgery carries some risks, which include:
  1. Bleeding
  2. Infection at the incision site
  3. Allergic reaction to the anesthetic
  4. Blood clots
  5. The scar may grow, change color, or otherwise become more noticeable, though there is approximately a 1% chance that the scar will look significantly worse
  6. Numbness
  7. Recurrence of scar
  8. Keloid formation (or recurrence)
  9. Separation of the wound
  10. Darkening of the new scar due to sun exposure
However, when performed by an experienced surgeon, scar revision is generally safe. Ensure that you discuss all the scar revision side effects, scar revision risks, and complications as well as benefits of scar revision surgery with your doctor before the surgery to help to minimize the chance of experiencing complications. The exact risks are specific to you and differ for every person, so if you have any concerns or worries about the scar revision procedure and the risks and side effects involved, asks your scar revision surgeon to explain how they may apply to you.

 

Questions to Ask a Surgeon About a scar revision procedure

Knowledge is power so arm yourself with the facts before making any decision about scar revision surgery. Here is an essential check list to help you find the right Perfect Yourself Surgeon.

  1. Am I a good candidate for scar revision surgery?
  2. Are my described expectations realistic?
  3. Where is the surgery performed?
  4. How long will the procedure take?
  5. What kind of anesthesia is used?
  6. What is your experience in performing scar revision surgery
  7. Can I see your qualifications?
  8. Ask to see any scar revision before and after photographs of recent scar revision surgeries
  9. What percentages of your scar revision surgery patients have had significant post-surgical complications? (surgeons should disclose this information to you)
  10. Who will be assisting my surgery? Can I see their qualifications?
  11. How much will my scar revision surgery cost?
  12. Do you offer patient financing? (Flexible payment schemes for your surgery)
  13. Will you repeat/correct procedures if the agreed goals are not met? If this is the case, will I be charged again?
  14. Ask to observe the exact procedure you are considering before you decided to have surgery if you are unsure (this could be on videotape or in real life).
  15. What is the recovery and healing period for scar revision surgery? When can I resume full normal activity?
  16. Have you ever had your malpractice insurance coverage denied, revoked, suspended?
  17. Ask for and follow up on patient references (these can be invaluable to finding out what your surgeon is really like and the level of customer satisfaction he/she has received in the past)

 

Skin Rejuvenation Checklist

Skin Rejuvenation Checklist

Knowledge is power so arm yourself with the facts before making any decision about Scar Revision & Repair procedures; click here for an essential check list to help you find the right Perfect Yourself skin specialist.


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Be sure to also visit our Expert Advice page where you can find great questions from real visitors, Answered by real plastic surgeons, cosmetic dentists, and skin rejuvenation specialists.
 


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