Scar formation is normal aspect of wound healing from a traumatic event or surgical procedure. Lacerations and scars of the face pose a unique challenge. They are more difficult to conceal, and appropriate planning and skill is necessary to achieve both a functional and cosmetically appealing result. An ideal scar is a nearly imperceptible fine line that falls parallel to a naturally occurring line or crease. To achieve an ideal scar, the surgeon must have an excellent understanding of the skin anatomy, have meticulous skin handling techniques, and understand the patient’s expectations. Most importantly, both the surgeon and patient should be aware of the limitations of the surgical procedure.
When is it necessary to have a scar revised?
Creases and lines are normal on the face as long as they conform to what the viewer’s eye perceives as normal facial anatomy. When a scar deviates from what one expects to see on a face, it becomes noticeable, and can be considered for revision. Techniques used for scar revision are not intended to eliminate a scar, but instead make it less obvious to the viewer. With careful planning, scar tissue can be minimized and optimized. A surgeon’s attention to detail is critical in planning and executing a scar revision.
Timing of Scar Revision
Scars continue to change and improve over the course of approximately one year, at which time scar revision can be planned. However, this process can be longer, especially in children. Early scar revision (within 1 year) is generally only undertaken if there is a gross deformity that would benefit from a more immediate repair.
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Nonsurgical options can be used as a conservative way to improve scarring, or can be used as an additional tool after a scar revision.
- Limiting sun exposure and judicious use of sunblock is crucial after surgery to help prevent hyperpigmentation.
- Silicone sheets can be placed over scars to improve scar thickness, size, color, and texture.
- Steroids can be injected to soften and flatten a scar.
- Laser therapy is an adjunct treatment that can be used to treat both hypertrophic scars and keloids.
- Fillers can be used to correct contour depressions from scars.
- Botox can be used during scar revision to prevent movement of the surrounding tissue, and improve the appearance of the resultant scar.
Dr. Rogal is available to meticulously close lacerations that may arise, or for consultation regarding scar revision procedures.
