HYPERTROPHIC SCAR REVISION; KELOID REVISION; SCAR REPAIR
Definition
Surgical
procedure to improve or minimize the appearance of scars, restore function, and
correct disfigurement resulting from an injury, lesion, or previous surgery.
Description
Scar
tissue forms as skin heals after an injury (such as an accident) or surgery. The
amount of scarring may be determined by the size, depth, and location of the
wound; the age of the person; heredity; and skin characteristics including color
(pigmentation).
Surgery to revise scars is done while the patient is awake, sleeping (sedated),
or deep asleep and pain-free (local anesthesia or general anesthesia).
Medications (topical corticosteroids, anesthetic ointments, and antihistamine
creams) can reduce the symptoms of itching and tenderness. Scars shrink and
becomes less noticeable as they age, therefore, immediate surgical revision is
delayed until the scar lightens in color, which is usually several months or
even a year after a wound has healed.
A keloid is an abnormal scar that is thicker, different color and texture,
extends beyond the edge of the wound, and has a tendency to recur. It often
creates a thick, puckered effect simulating a tumor. Keloids are removed at the
point where it meets normal tissue.
Massive injuries (such as burns) can cause loss of a large area of skin and may
form hypertrophic scars. A hypertrophic scar can cause restricted movement of
muscles, joints, and tendons (contracture). Surgical repair includes removing
excessive scar tissue and a series of small incisions on both sides of the scar
site, which create V-shaped skin flaps (Z-plasty) may be used. The result is a
thin, less noticeable scar because the wound closure following a Z-plasty more
closely follows the natural skin folds.
Skin grafting involves the taking a thin (split thickness) layer of skin from
another part of the body and placing it over the injured area. Skin flap surgery
involves moving an entire thickness (full thickness) of skin, fat, nerves, blood
vessels, and muscle from a healthy part of the body to the injured site. These
techniques are planned when a considerable amount of skin has been lost in the
original injury, when a thin scar will not heal, and when improved function
(rather than aesthetic reasons) are the primary concern. Secondary procedures
may later be necessary to achieve appropriate aesthetic results.
Indications
No
scar can be removed completely. The degree of improvement will depend on
variables such as the direction and size of the scar, the age of the person,
skin type and color, and hereditary factors that may precondition the extent of
the healing process.
[Rhinoplasty][Blepharoplasty][Facelift][Tummy Tuck/Abdominoplasty][Chin Augmentation]