What Is Scar Revision?

Scar revision is a broad term that’s used to describe techniques that minimize or improve the appearance of scars. Simply put, scars are growths of fibrous tissue that form as part of your body’s healing response to an injury.

There are several different ways to perform scar revision, and sometimes doctors will combine methods. Your treatment options will depend on the type of scar you have, the severity of the scar, your desired outcome, and other factors. Some examples of scar revision include:

Scar excision With this procedure, doctors remove the scar surgically and close the skin.

Skin graft Surgeons remove the scar and take healthy skin from another area of the body to cover the affected spot.

Skin flap This is similar to a skin graft, but the transferred skin has its own blood supply.

Z-plasty With Z-plasty, surgeons make a Z-shaped incision through the scar tissue and some healthy skin. The Z-shape allows them to create pointed flaps that are used to reposition the scar or change its direction, so it’s less visible.

Surface treatments Laser resurfacing, dermabrasion, light therapy, chemical peels, and bleaching agents are used to smooth the surface of the scar and lessen discoloration.

Tissue expansion Tissue expansion involves helping the body grow new skin to cover a scar. Doctors place an inflatable balloon under the skin near the scar and gradually stretch the skin, which is redistributed to replace damaged areas.

Cryotherapy With cryotherapy, doctors use a medication to freeze off the scar.

Injectables Sometimes steroids or fillers made from natural or synthetic products are injected into the scar tissue to help improve its appearance.

Pressure therapy This involves wearing a pressure appliance over the scar to help lessen its thickness.

Additionally, other nonsurgical treatments, such as topical medicines, may be used along with scar revision procedures to smooth out the skin’s surface and promote healing.

Why Would You Need Scar Revision?

You might need scar revision if you would like to improve the appearance of a scar. Scars can result from injuries due to:

Burns

Surgery

Accidents

Illnesses

Acne or other irritating skin conditions

Scars can vary in size, shape, color, and texture. There are different types of scars. They include:

Hypertrophic scars These scars are usually raised, thick, and red. They can appear dark or light and often form right on the site of the wound.

Keloids Keloids are thick, raised scars that can itch or cause pain. They may grow much larger than the wound that caused the scar. These scars usually affect the face, ears, neck, chest, or shoulders.

Contractures Contractures cause skin to tighten and make it difficult to move. They often occur after a burn injury.

Stretch marks They happen when skin stretches or shrinks rapidly and leads to damage in the connective tissues underneath. Stretch marks usually develop on the breasts, thighs, stomach, or upper arms.

Atrophic scars These scars have a sunken appearance and look like small indentations in the skin. They usually result from acne or chickenpox.

Flat scars This type of scar, which is usually pink or red, flattens as it heals.

A good candidate for scar revision is an individual who is physically healthy, doesn’t smoke, doesn’t have any active skin diseases, and has realistic expectations for their results.

How Is Scar Revision Performed?

There are many ways to perform scar revision. You and your doctor will choose the technique that will offer you the best outcome.

If you’re having a surgical procedure, your doctor might cut out your scar and stitch up the area. With Z-plasty, scars are repositioned so they’re not as noticeable. Doctors can also cover the scar with transplanted skin that’s taken from another area of your body with a skin graft or skin flap approach.

Or, you might have a tissue expansion procedure to slowly stretch the skin and replace the scar tissue. This procedure can sometimes be a complex process that involves multiple procedures to achieve the desired outcome.

If you’re having a surface treatment, doctors may use dermabrasion to smooth the skin, bleaching agents to lighten the skin, or chemical peels to improve texture and color. Laser therapy is another option that targets the surface of the skin and allows healthy skin to develop at the site of the scar.

Dermal fillers are often helpful for scars that are sunken or depressed.

Alternatively, steroid injections can improve the appearance of raised scar tissue.

With cryotherapy, doctors apply extreme cold to destroy scars.

Pressure therapy involves wearing a bandage or dressing that applies pressure to the wound while it heals. This extra tension may help lessen the size of a scar.

How to Prepare for Scar Revision

Your doctor will give you detailed instructions on how to best prepare for your procedure. You may have to wait to have the treatment if your scar hasn’t matured enough.

Before your surgery, you should tell your provider about all the medicines and supplements you take. Additionally, it’s important to let your doctor know about your existing medical conditions and any drug allergies you have.

Before undergoing scar revision surgery, you may have to:

Stop taking certain medicines or adjust your dosages

Stop smoking

Get lab tests

If you’re receiving anesthesia for your scar revision, you may have to fast for a certain amount of time before your scheduled procedure.

On the day of your procedure, avoid applying any lotions or makeup to the area being treated.

It’s a good idea to ask your doctor if you can see before and after pictures of cases that are similar to yours. That way, you’ll know what kind of results to expect from your scar revision.

What Are the Risks of Scar Revision?

The risks associated with scar revision will depend on the type of procedure you have. You and your doctor should discuss all the potential negative outcomes before scheduling your surgery or treatment.

Some possible risks of scar revision surgery include:

Bleeding

Infection

Problems associated with anesthesia

Blood clots or cardiac problems

Hematoma

Asymmetry or poor results

Fat necrosis (when fatty tissue deep in the skin dies)

Seroma (an accumulation of fluid)

Numbness

Persistent pain

Poor healing

Keloid formation (thickened scar)

Skin loss

Skin discoloration or swelling

Loose skin

Recurrence of the scar

What to Expect During Scar Revision

If you are having a surgical procedure, you’ll likely be given anesthesia to make you more comfortable. There are different anesthesia options. They include:

Local anesthesia (an injection that numbs the area)

Intravenous sedation (“twilight” sedation)

General anesthesia (medicines that put you to sleep during surgery)

Your doctor will recommend the best way to ensure that you don’t feel pain during the surgery or treatment.

With surface procedures, such as lasers, you might feel warmth or discomfort. If so, doctors might apply a topical anesthetic, inject a numbing anesthetic, or give you an oral sedative, depending on the therapy that’s used.

What Are the Complications and Side Effects of Scar Revision?

After your procedure, you may notice skin discoloration, discomfort, or swelling that lasts one to two weeks.

Scar revision can cause complications, such as bleeding, infection, blood clots, hematomas, reactions to anesthesia, or cardiac issues.

You should seek medical attention right away if you develop the following symptoms:

Shortness of breath

Chest pain

Irregular heartbeat

A high fever, chills, or other signs of infection

You should let your doctor know if you’re having persistent pain, swelling, or numbness; your skin isn’t healing normally; or your results aren’t as expected.

Care After Scar Revision

Your aftercare routine will hinge on the type of procedure you had. You should follow any wound care instructions your doctor provides.

Healing from scar revision surgery can take several weeks, and it could take months before you see the final results.

If you have stitches, your doctor will probably remove them after three to four days if they’re on your face, or after five to seven days if they’re on another part of your body.

You may have to apply an elastic dressing or light dressing to the area after surgery.

Most people are able to resume normal activities shortly after their procedure, but it depends on the type of surgery you have. Your doctor will tell you what activities to avoid. You may have to be careful not to stretch the new scar.

You should apply sunscreen when outdoors and keep away from the sun while your scar is healing.

It’s possible to achieve desired results in one procedure, but you may require another scar revision surgery or treatment in the future.

DQH Knowledge drop: In your 20s, your skin cell turnover decreases. (Cell turnover is a key component in keeping your skin youthful.) You know what else slows down? Your collagen production. Starting in your 20s, collagen decreases by about 1 percent per year. Should you want to prevent fine lines and wrinkles, start by eliminating behaviors that contribute to premature aging. “If it’s bad for you, it’s bad for your skin,” says dermatologist Michel Somenek. “Cigarette smoking reduces blood flow to the skin and causes premature wrinkling and a dull skin texture. Making the repeated pursed motion to inhale can also cause smoker’s lines. Alcohol and recreational drugs are toxins for the skin that damage its cellular structure and DNA,” Somenek tells us. “The faster you eliminate vices while you are young, the better chance your skin and body have to recuperate.” Also, adopting an anti-aging routine in your 20s is key. After all, the best offense is a good defense. We spoke to Somenek and experts Joshua Ross and Audrey Kunin to find out more. Keep reading for the best anti-aging products for your 20s, according to skincare professionals. Sunscreen “We all know that the sun is the number one cause of skin aging and starting the prevention in your 20s is very important,” Ross says. “The majority of your sun damage won’t start to appear until you’re in your 30s, so don’t wait until you see it surface or you’ll be behind the curve. Stay ahead of it with a good-quality zinc-based sunscreen worn daily.” Farmacy Green Defense Daily Mineral Sunscreen An invisible sunscreen with SPF 30, plus botanical extracts meant to protect skin with tons of antioxidants. Bonus: It’s clean and fine to use under makeup. Bareminerals Complexion Rescue™ Tinted Moisturizer Broad Spectrum SPF 30 Although we recommend you use your SPF and moisturizer separately, we also understand moments when you don’t have time or energy for that extra step. For those times, this bareMinerals moisturizer is a great thing to have on hand. Vitamin C Serum “A great introduction to anti-aging is to start with a vitamin C serum in your morning skincare routine,” Ross says. “It’s a powerful antioxidant that will neutralize free radicals and brighten the skin.” He adds that it’s a great way to counteract the effects of the sun’s harmful rays, which, as previously mentioned, are among the biggest causes of premature aging. Drunk Elephant C-Firma™ Vitamin C Day Serum The Drunk Elephant C-Firma is a lightweight serum that promises to give skin a glow by combining the brightening powers of vitamin C with ferulic acid, l-ascorbic acid, and vitamin E. The included sodium hyaluronate is meant to replace hydration loss, so you shouldn’t have to deal with any irritation. Sunday Riley C.E.O. Rapid Flash Brightening Serum This potent serum is jam-packed with vitamin C (15 percent, to be exact), which means it’s a potential superstar at both brightening skin and dousing it in antioxidants. Peptides Using peptides on your skin has many benefits, says Somenek. “The skin barrier is what defends the body against pollution, UV rays, bacteria, and toxins. It can be damaged by several everyday factors. Using topical peptides aids in building a stronger barrier,” he says. “Peptides comprise elastic fibers, which are a type of protein. These fibers help to make skin appear taut and firm. Peptides can also help repair damaged skin, relieve inflammation, and even out skin tone. Some peptides can kill acne-causing bacteria that is common in 20-somethings.” Kunin agrees, saying, “Peptides are an excellent entry point for supporting collagen.” She recommends looking for face and eye treatments that contain these collagen-boosting powerhouses. Charlotte Tilbury Magic Eye Rescue Cream This Charlotte Tilbury super-emollient eye cream has a base of coconut oil and shea butter (read: it’s incredibly hydrating). Botanicals plus peptides are meant to help reduce dark circles and boost collagen, respectively. This creamy moisturizer serves up potent collagen-boosting peptides and pycnogenol, and antioxidant-rich vitamin C. “Instead of sitting on top of the skin, peptides penetrate the outer layer so they go deep. The ‘signals’ they send tell the cells to produce elastin and collagen, which are needed for youthful-looking skin,” explains Somenek. At-Home Peel Pads Remember that skin cell turnover fiasco we talked about earlier? One way to help support it is by exfoliating. “Exfoliation is important to help keep skin fresh and luminous,” Kunin says. She recommends using at-home peel pads as an easy and effective way to exfoliate. “The goal in your 20s is to fight the slowing pace of cell turnover. It is wise to use products that gently exfoliate, yet still remove oil and other impurities. Products that have Alpha Hydroxy Acids (AHA) or Beta Hydroxy Acids (BHA) are a good choice.” According to Somenek, you should only exfoliate two to three times a week. “People of all ages are guilty of over-exfoliating and that can be too much of a good thing,” he says. Dermadoctor Kakadu C Intensive Vitamin C Peel Pad A few swipes of this Derma Doctor powerful peel pad promise to leave your skin glowing and smooth, thanks to the seven (yes, seven) types of chemical exfoliants, including AHA and BHA. It also contains vitamin C via Kakadu plum extract for added brightening and antioxidant protection. KEY INGREDIENTS Kakadu plum extract is sourced from the Kakadu plum, a fruit grown in northern Australia. It contains vitamin C, which restores the skin’s natural barrier, increases collagen production, and soothes irritation. Dr. Dennis Gross Skincare Alpha Beta® Universal Daily Peel Pads These are the gold standard of peel pads, with a cult following and over 900 five-star reviews on Sephora. They’re easy to use and contain a blend of anti-aging exfoliating acids. Emollient Night Cream “In your 20s, you need to start upping the hydration in your skincare routine. You may have been cautious of over-moisturizing because of acne in your teens, but as you enter your 20s, your skin transitions and becomes drier,” Ross says. “I recommend an emollient night cream added into your evening skincare regimen.” “Twenty-somethings need to make sure that they are not using creams that will clog their pores and cause excess oil production,” says Somenek. Opt for non-comedogenic products. Cerave Skin Renewing Night Cream One great choice is the CeraVe Skin Renewing Night Cream, which is a non-comedogenic night cream that leaves skin soft and glowy. It combines the moisturizing powers of ceramides and hyaluronic acid. RoC Retinol Correxion Max Hydration Creme “The best night cream ingredients contain retinol, benzoyl peroxide, and/or salicylic acid or hyaluronic acid. The goal is to moisturize, yet remove excess oil,” says Somenek. This Roc Retinol Correxion cream fits the bill as it contains both hyaluronic acid and retinol so it promises to moisturize while also being non-comedogenic.

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