Scar Revision

W

hile many scars fade over time, some patients experience disruptions to healing. These individuals are left with raised, discolored, or otherwise deformed tissue. Patients may feel unhappy about their scars, especially when they cause discomfort or are in prominent areas. Centers for Neurosurgery, Spine & Orthopedics (CNSO) offers cosmetic and reconstructive surgery, including scar revision surgery to restore smooth, clear skin. Serving at locations near you across northern New Jersey, the award-winning CNSO team helps patients feel good about their appearance.

Quick Facts About Scar Revision Surgery

• Scar revision surgery is a cosmetic procedure that aims to minimize a scar.
• Patients are good candidates for scar revision surgery if they are in good physical health and have an uncomfortable or disfiguring scar that they want altered.
• Types of scar revision treatments include topical treatments, injections, laser therapy, dermabrasion, and surgical revision.
• Scar revision does not erase scars, but it can provide reduced discomfort, improved mobility, and an improvement in appearance.
• CNSO offers scar revision surgery for patients in northern New Jersey.

What Is Scar Revision Surgery?

Scar revision surgery is a type of cosmetic surgery that attempts to minimize a scar. Scars are visible marks left behind after a wound heals. They are unavoidable consequences of many types of wounds, including injuries, surgeries, and acne. There are several types of scars:

• Hypertrophic scars: These thick clusters or bands of scar tissue develop directly at the wound site. They can grow wider over time.
• Keloid scars: These scars extend beyond the edges of the original wound and are most common in areas with little underlying fat.
• Contracture scars: These scars feature tight tissue that pulls together. They are caused by large amounts of tissue loss and can restrict movement.

Scar development can be unpredictable. Some are more noticeable than others due to size, location, or poor healing. If a scar is highly visible or uncomfortable, scar revision surgery can reduce its impact.

Who Is a Candidate for Scar Revision Surgery?

Scar revision is a very personal procedure. Obvious scars can affect a person’s self-image, leading to body insecurities, depression, and anxiety. They may also cause physical discomfort. These are common reasons a patient might consider scar revision surgery:

• Large or strangely shaped scars
• Scars in unsightly locations
• Raised or depressed scars
• Discolored or coarsely textured scars
• Tight scars that restrict movement
• Itchy or painful scars

To be eligible for scar revision surgery, patients should be physically healthy. They should not smoke, as smoking can interfere with healing after surgery. They should also have underlying conditions, such as acne or other dermatologic conditions, actively treated. Patients can speak with a CNSO provider to find out whether scar revision surgery is right for them.

Types of Scar Revision Techniques

CNSO offers multiple approaches to scar revision, including both non-surgical and surgical treatments. Depending on the scar to be treated, patients may have access to:

Non-Surgical Options for Scar Revision

The CNSO medical team applies a conservative philosophy toward treatment. Physicians prioritize non-invasive treatments whenever possible, only resorting to surgery when it is necessary to achieve the results that patients desire. Non-surgical techniques that can improve scar appearance include:

• Topical treatments, including dressings and gels
• Epidural steroid injections
• Skin fillers
• Laser therapy
• Chemical peels and dermabrasion

Non-surgical treatments typically require several applications to achieve the best results. They are most effective for smaller scars that do not require extensive revision.

Surgical Options for Scar Revision

Surgery is most often recommended for large, severe scars, especially those that impede function or range of motion. CNSO plastic surgeons are experienced in multiple types of scar revision surgery, including:

• Excision: The surgeon cuts away the scar tissue, then closes the resulting defect with sutures
• Skin grafting: For larger scars, the surgeon may use a graft of healthy skin to replace the scarred tissue. Grafts are typically taken from elsewhere on the patient’s body.
• Tissue expansion: The surgeon places an inflatable balloon under the skin near the scar. Once the skin has been stretched sufficiently, it can be moved to cover the scar site.
• Flap closure: Rather than remove the scar completely, surgeons may instead reposition it to make it less conspicuous or to improve flexibility.
• Z- or W-plasty: The surgeon makes a Z- or W-shaped cut over the scar. This breaks up the scar tissue, providing better flexibility after the incision heals.

The most appropriate procedure depends on the type of scar to be revised, its size and location, and the patient’s goals for revision.

Combining Treatments for Best Results

Some large scars may require a more complex approach to revision. When one type of treatment is insufficient, physicians combine treatments for better results. Topical treatments may be used to make a scar less visible before it is repositioned with flap closure. A combination of steroid injections and Z-plasty may be used to reduce pain and improve mobility for a large contracture.

What to Expect During the Scar Revision Process

Scar revision treatment begins with a detailed consultation. At CNSO, the patient meets with Dr. Hakan Kutlu, an award-winning, board-certified plastic surgeon, to discuss the scar to be revised, the patient’s goals, and the options available. Treatment plans are customized according to scar type and patient goals.

Most scar revision surgeries are performed as outpatient procedures, meaning that patients do not stay at the hospital. Depending on the scar location, general anesthesia is usually not used, though a local anesthetic may be applied to prevent pain during the operation. How long surgery takes depends on the method used. All revision surgeries are unique, so patients should speak with Dr. Kutlu about what to expect from their treatment.

Recovery and Results

Recovery timeline varies between individuals. Patients may take weeks or months to heal completely, depending on the size of their scar and the type of treatment used. Following Dr. Kutlu’s recovery instructions is crucial to ensure a smooth healing process with no complications.

Scar revision improves scars but does not erase them. Patients who receive excision or a skin graft may have a new scar after surgery. The new scar is planned to be less conspicuous or to restore function, making an overall improvement. Other treatments do not remove the scar but will make the scar less noticeable and restrictive. Patients will enjoy enhanced comfort and function and a clearer appearance than they had before their treatment.

Find Expert Scar Revision Treatment Near You in New Jersey

Living with a severe scar may be discouraging, but a solution may exist. Centers for Neurosurgery, Spine & Orthopedics has a comprehensive care team, including cosmetic surgeons, interventional pain management physicians, physiatrists, rehabilitation specialists, and certified physical therapists who collaborate to provide personalized care for patients. CNSO has locations near you across northern New Jersey, including Bergen, Passaic, Essex, Morris, Union, Middlesex, and Hudson counties. Contact CNSO to learn more.

Frequently Asked Questions About Scar Revision

How long does it take to see results after scar revision surgery?

Scar revision surgery provides immediate results, though incisions may take a few weeks or months to heal.

Will the scar come back after revision surgery?

Surgery results are permanent, and scars should improve after treatment. While surgery may leave a new scar, the goal is to provide a better appearance than the old scar.

Can all types of scars be revised?

All types of scars can be revised, but the effectiveness of revision can vary depending on the type of scar, its size, and its location.

Is scar revision covered by insurance?

Scar revision for cosmetic reasons is considered an elective surgery, meaning that it is usually not covered by insurance unless it is related to a specific motor vehicle accident or work-related injury. There may be coverage options for scar revision to restore mobility.