Scar Revision Surgery

Indications:
1. Old injury scars
2. Old poorly stitched scars

What is Done?
Scar is cut out and removed, and skin is stitched with fine materials

How many stages?
One or more depending on scar

Anaesthesia: Usually local anaesthesia
Rest: No rest is required
Stitches: Removed in 5-6 days. If you are from outstation, absorbable sutures can be used
Result: Best results in 6 months to 1 year

Will the scar disappear completely?

No, it will improve a lot and become very faint- visible only on close inspection.

Will the result be immediate?

No, scars take much time to mature and improve after surgery. Give it six months time.

Do I need to follow any precautions after surgery?

Yes, regular follow-up visits for six months are necessary apart from certain creams.

I am told that result differs from person to person according to skin type and healing quality. What does it mean?

There are six types of skins. Fairest and delicate Scandinavian skin is type one, and thickest dark African skin is type 6. In between these are other skin types from fairer to darker. The tendency of scarring is least in fair, type one skin and maximum in dark type 6 skin. Indian skin is type 4 to 5. Fairer skinned people have better scars than darker people.

What is keloid scar?

A keloid is a type of scar that does not stop growing even after the skin is healed. It may grow bigger with time, may be elevated, hard, red and itchy and sometimes painful. A keloid can sometimes occur after a pinprick, a pimple or without any noticeable injury or surgery. A keloid is more common on the shoulder, chest and back.

What is the treatment of keloid scar?

Prevention is better than cure. After any injury or surgery if the scar is becoming elevated and itchy consult your plastic surgeon immediately. Fresh keloids can be treated without surgery by injecting steroids into keloid many times, application of pressure and silicon sheet. Surgery is done only for a few cases because any surgery will cause further keloid. This can be prevented by doing surgery and injecting a steroid into the scar after surgery 3-4 times and follow-up with the plastic surgeon for a long time to detect and suppress early reformation of the keloid.

What is a hypertrophic scar?

A hypertrophic scar is an elevated bad looking scar and a milder form of a keloid. Treatment is same as the keloid.

My father has a keloid scar. Does it mean I also have keloid tendency?

You may have keloid tendency.

My previous operation scars are fine, what are my chances of developing bad scar after my next surgery?

Chances of bad scarring are very low but results also vary from area to area, and some areas of the body are more prone to scarring than others.

I had met with an accident some years ago, and the scars on my arm are not good. I am now Planning to have plastic surgery. Am I likely to have severe scars again?

Scars of plastic surgery is better than other scars.

Do self-absorbable stitches give the best result?

Plastic surgeons stitch the wound in layers. Absorbable stitches are used in deeper layers and fine non-absorbable stitches on the skin surface. Outer stitches are removed in 4 to 5 days. These unique non-absorbable stitches are very smooth, do not leave marks and are not painful during removal. Absorbable stitches on the skin are not preferred because they absorb slowly and may leave marks. Sometimes absorbable sutures under the skin alone are used, and no stitches are applied on the skin. Your plastic surgeon is the best person to decide which kind of technique will suit you the most.

Is it better if my skin is closed with glue rather than the stitches?

Plastic surgery stitches give the best result and do not leave stitch marks. Glue is only for uncooperative children.

My daughter had stitches on her face due to fall. Now she is six years old. What is the right age for scar revision surgery?

If she is not very affected by scar and if you can wait it is best to delay the surgery as late as possible that is 16 years or later. There is a chance that the scar may fade significantly on its own. Grown ups are not scared of local anaesthesia and also with maturing of skin healing tends to be better. If the scarring is too bad and child is being pointed out by others and developing psychological problems, then surgery can be done earlier.

Is laser better than surgery for scar removal?

Different scars respond to different treatments. Scars that respond to surgery do not respond to laser and vice versa. Generally speaking, very few types of scars respond to laser.