Scar Revision

What is Scar Revision?

Scars are a testament to a point in time  and  mark as a way to remind us of where our journey has taken us. A scar we are born with is the umbilical cicatrix, a reminder of our first adventure with our mother. Scars have fascinated us from soldiers showing their battle scars to the lightning bolt on a certain wizard`s forehead.

A patient comes to a plastic surgeon for their scars for mainly two reasons, one being a functional deficit where the scar impedes complete movement of the joint and the second being a cosmetic deformity, which impedes their confidence or is a reminder of an untoward incident .

An ideal scar by definition is thin and flat, has good colour match with the surrounding skin,is oriented along the relaxed skin tension lines, and does not produce any distortion of adjacent tissues. A scar can vary from a immature to a mature scar, from a linear hypertrophic scar to a large keloid.

The outcome of a scar depends on three factors i.e the expertise of the surgeon which emcompasses the way of operating and the post-operative care taken, the second being the patient itself which depends on the age of the patient and the presence of systemic diseases like Diabetes Mellitus, Chronic Renal failure and finally the status of the wound itself on presentation i.e presence of infection and its location on the body.

The post- operative  period of healing and its maturity is as important as the surgery itself. Cleaning of the suture line and removal of sutures at the right time with with silicone/pressure therapy  is the way to go.

As it turns out ,if  the scar present on the body turns out unsightly, there are a number of ways of reducing the appearance of the scar. If it an extremely unsightly scar , excision of the scar and resuturing is an option. Other geometrical plastic surgery techniques like Z plasty, W plasty is widely accepted. A depressed scar can be improved by a technique called subcision and the residual corrected with a filler.

A scar is the nature`s way of healing and the process can be improved with adjuvant therapy during this period which usually takes about 6 months to a year. A multimodal treatment which consists of injectables like Triamcinolone, 5 FU are used. The use of Radiotherapy in the treatment of keloids is well established. The use of lasers has added another arrow in the armamentarium of scar management helping scar remodelling and improving their appearance.

 

In conclusion, you have every right to look the way you want to.

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