In many ways, our skin tells the story of our lives. But sometimes, for different reasons, we’d prefer to re-write parts of that story. If you’re someone with noticeable scars on your body, you might know this feeling all too well, inspiring you to seek out more information about scar revision. Maybe you’d prefer not to be reminded of what caused your scarring to occur, or maybe you’d really love to wear whatever you feel like without feeling self conscious. Maybe it’s become tiresome to be asked about your scars.
For all these reasons and more, scar revision can be a good option for scars that haven’t faded as hoped. This often leads to larger, noticeable marks on the skin, sometimes with visible texture and raised or depressed areas. So let’s talk about scars and what we can do if you’d like to change the look of some of your own.
What exactly are scars, anyways?
The skin is the body’s largest organ, and all of the things it does to keep us healthy and comfortable are pretty incredible. When the skin is injured, or if incisions are used for surgery, it will undergo a healing process to repair itself. Sometimes this healing process can affect the way that scar tissue develops, depending on how evenly it heals, or if there is tension on the skin. But sometimes a wound or incision can heal really well but a visible or prominent scar will develop anyways.
Our skin contains different fibres to optimize its functions: collagen gives strength to its structure, while elastin fibres allow for flexibility. When the skin is injured, it only produces collagen in order to repair the injury. Since scars don’t have the same elastin component, they feel tougher and less flexible than the rest of the skin. This affects its texture and appearance, as scar tissue is often darker or lighter than the tissue that surrounds it.
Most common scars are caused by minor injuries and small surgical incisions and really only cause surface or colour irregularities. These are not usually the types of scars patients are looking to correct with scar revision.
The types of scars we usually see in scar revision cases
Keloid Scars – keloid scarring extends beyond the original injury site and are a kind of “malfunction” of the normal healing process and are usually a hereditary condition, but not always! We’ve seen them occur for people at different ages with different skin injuries. They create raised, often tough tissue, and can be itchy or painful for the person experiencing them. Keloids most commonly form on areas of the body with less fatty tissue, like the face, chest and shoulders.
Hypertrophic Scars – hypertrophic means that the scar tissue is raised and its surface sits higher than the skin that surrounds it. They can appear either darker or lighter than the original skin tone. Unlike keloid scars, they are limited to the area of the original wound.
Atrophic Scars – atrophic means the opposite, that the scar forms a shallow or indented area whose surface sits lower than the skin that surrounds it. These are commonly the type of scars we see as the result of chicken pox, or from more severe acne scarring, as with cystic acne.
Scar revision is a procedure that use a surgical or non-surgical approach to minimize or eliminate the appearance of scarring, or to remove the scar and replace it with an expertly closed surgical scar.
Does scar revision really work?
Unfortunately, we can’t turn back the clock to the point where your skin is totally untouched. But we do have a lot of techniques at hand to reduce the appearance of scars, and in some cases, we’re able to make them look almost invisible. For our patients who have had issues with hypertrophic or keloid scarring, that difference can be a life-changing one.
Scar revision surgery works because plastic surgeons are specially trained in wound-closure techniques. They know exactly how to create a less noticeable scar that is easily hidden, concealed, or barely visible.
Sometimes it’s not possible for doctors to take the necessary time required to follow these intricate techniques when closing wounds (for example, if they’re performing a potentially life-saving surgery on a patient with an injury, health and safety is always the highest priority). Sometimes wounds heal without surgical intervention. And as with keloids, sometimes scar tissue develops in unexpected ways.
No matter the original cause, if you have a surgical scar revision procedure with us, your surgeon simply replaces your scar with a new incision that is closed using their expert techniques.
What about scar revision with lasers?
For non-surgical scar revision, it really depends on the nature of the scar. Treatments like lasers, dermabrasion and microneedling can all be used to minimize the appearance of some scar tissue. Lasers can help lighten hyperpigmentation, while microneedling, dermabrasion and laser resurfacing can help alter the scar’s texture.
Not sure if non-surgical or surgical scar revision would be the best option for you? Consultations with our plastic surgeons are always free, so you can come in and be evaluated by an expert. They can let you know realistic expectations for what these different approaches can achieve and help create a treatment plan that works for your goals.
As long as your injury or incision is fully healed (meaning no scabs or open areas), you could be a good candidate for any of these procedures. If your surgeon determines that your best option is scar revision surgery, you may be asked to wait a certain amount of time to ensure that your scar has stopped changing or evolving through the healing process to make sure they can achieve the best result possible. If you’ve had your scar for over a year, then this likely will not be a concern.