Scar Revision

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Scars can occur from surgery or from injury.  A scar is the result of the normal healing of the body, and it is inevitable that scars will occur when there has been either surgery or injury.  However, it may be possible to try to reduce the appearance of your scars.

How Scars Occur

When we do plastic surgery, we know that scars will result.  There are a number of factors that contribute to the development of more-noticeable scars, including how the injury or incision was made (how much damage was done to the surrounding tissues), how the injury or incision was closed (if it was closed), how the healing injury or incision was treated after it had been closed, and the genes of the patient.

Unfortunately, some people just develop thicker and more noticeable scars than others.  A good way to get an idea of the kind of scars that your body forms is to look at the scars you have already formed.  For example, a woman who has had a Caesarian Section and who is thinking about a Tummy Tuck could look to the C-Section scar to get an idea.

However, local factors are likely to play an issue.  One of the most important of these is wound tension.  We often see thicker scars when the wound is under tension after repair.  In some cases, such as Tummy Tuck, tension is a desired result of surgery.  In other cases, such as when larger tattoos are removed, tension may be a by-product of the primary goal of surgery.

Labiaplasty, scar revision, fat transfer to breasts - Scottsdale, AZ - Over the last few years I have been reading about labiaplasty partially for cosmetic reasons but mostly for comfort and a more positive sexual experience. The tugging of the excess skin was the biggest issue for me. I was considering a few different doctors, but after meeting Dr. Nachbar last year I felt that I did not need to continue looking for a doctor. It's not the most enjoyable...

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Liposuction, Scar Revision - Dr. Nachbar was referred to me by a friend and neighbor. I had a tricky situation with poor scarring and he was able to remove the scar and provided special Embrace bandages to help with the healing. I've had several visits since, discussed my healing and other surgeries I might want/need and would highly recommend his office to anyone needing quality surgery with an amazing staff.

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Scar Revision, Tummy Tuck, Liposuction - Revised scars look better, tummy tuck revision looks much better than prior to surgery. Removal of "extra" areola from original breast lift looks much better.

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Breast Implant Revision, Breast Lift, Breast Reduction, Scar Revision, Tummy Tuck - All of my concerns were addressed and questions were answered. The doctor and assistant took them time in the consultation.

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What Can Be Done About Scars?

Unfortunately, there is nothing that will eliminate scars, and when a scar has occurred, the goal is to try to minimize its appearance and any interference with function caused by the scar.  There are a great number of interventions that may be appropriate for a given scar.

For example, we can remove the scar with surgical excision, and then close the resulting wound, with the hope that the new scar will be better than the old scar.  This is more likely to be successful when something about the closure is different the second time, such as more careful technique (especially if a plastic surgeon did not do the initial closure), or less tension the second time (because the skin has relaxed somewhat since the first closure.

A variation of scar excision and closure is a modification in the design of the scar with one of a wide variety of techniques.  One of these is the "Z-Plasty," which allows us to break up a tight scar, but there are many more revision designs available.

Other treatments of an existing scar can include injections, such as steroid injections, which can make a thick scar less thick, but which can result in a somewhat wider scar.  Laser treatments have been used, which can reduce the redness of a scar somewhat more quickly (although the redness tends to fade on its own over time anyway).  Microneedling is another treatment that has been used for scars.

Treatments you can do yourself include massage and silicone sheeting. 

Massage is often done with a lubricant, such as Mederma or Vitamin E oil (cut open a Vitamin E capsule to get the oil).  For this to work, the massage should be fairly firm, and preferably for fifteen minutes three times daily.  This is more likely to be effective in the weeks and months following healing, but can be tried with scars of any age.

Silicone sheeting can also be effective, by applying continuous pressure.  This sheeting is available at drug stores or online, and ideally is left on for 23 hours a day (i.e., except when you are taking a shower).

A preventive measure that can be used in the first few months following healing is a specialized silicone sheet with two lines of adhesive, designed to take tension off of the scar as it is healing, since we know that scars that heal under less tension tend to heal with less thickness and width.  An example of this is the Embrace® dressing, which is available online in different sizes.  This works best when started about four weeks after surgery, and kept on for about 60 days.  Each dressing can generally be left on for 10 days before being changed.  The dressing is applied with a special applicator so that the sheet is under tension when the adhesive is applied, and then pulls the two sides closer, so that they are under less tenion.

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Because there are so many possible interventions for thickened or noticeable scars, and because there is no treatment that eliminates visible scars, please make an appointment for a complementary consultation, so we can discuss your situation and what treatments might help.

Can scar revision completely remove my scar?

Scar revision can significantly improve the appearance of a scar, making it less noticeable, but it does not completely remove it. The effectiveness of the treatment depends on various factors, including the size, age, and depth of the scar, as well as the patient’s skin type and overall health. During your consultation, our specialists will assess your scar and discuss realistic outcomes based on your specific case.

What types of scars are more challenging to treat?

Certain types of scars, such as keloids and hypertrophic scars, are more challenging to treat due to their nature of excessive tissue growth beyond the original skin injury. These scars tend to be thicker, raised, and more visible. Your consultation will help determine the most effective approach for your specific scar type.

How long should I wait after an injury before considering scar revision?

It is generally recommended to wait at least one year after an injury or surgery before considering scar revision. This allows the scar to mature and your body to heal fully, which can make the revision process more effective. During this waiting period, the scar may also improve in appearance on its own. During your consultation, we can evaluate the maturity of your scar and discuss the optimal timing for treatment to ensure the best aesthetic outcome.

*Individual results are not guaranteed and may vary from person to person. Images may contain models.