When is Scar Revision Appropriate?
Scar revision may be considered when a scar is causing functional problems, significant cosmetic concern, or symptoms such as itching, tightness, or discomfort. Common indications include:
- Wide or stretched scars
- Hypertrophic scars (raised, firm scars within the original wound boundary)
- Keloid scars (scars that extend beyond the original wound boundary)
- Contracted scars causing restriction of movement
- Scars in an unfavourable position or orientation
- Scars following trauma, burns, or previous surgery
It is important to allow adequate time for a scar to mature before considering revision. Most scars continue to improve for twelve to eighteen months following the original injury or procedure, and revision is rarely appropriate before this period has elapsed.
Treatment Options
The most appropriate approach depends on the type and site of the scar. Options include surgical excision and reclosure, Z-plasty or W-plasty to reorientate a scar or break up a straight-line contracture, and dermabrasion. Non-surgical adjuncts such as steroid injections and silicone therapy may be recommended before or after surgery, particularly for hypertrophic or keloid scars.
Keloid scars require particularly careful assessment, as surgery alone carries a risk of recurrence. A combined approach is usually recommended and will be discussed in detail at consultation.
The Procedure
Most scar revision procedures are performed under local anaesthetic as a day case. More extensive cases may require general anaesthetic. Mr Lewis will advise on the most appropriate approach based on your specific circumstances.
Recovery
Recovery varies depending on the extent of the procedure. Wound care instructions will be provided and sutures removed at the appropriate interval. Long-term scar management, including sun protection and silicone therapy, is an important part of optimising the final result and will be discussed at your follow-up appointments.
Your Consultation
All consultations are with Mr Lewis personally. A realistic and honest assessment of what can be achieved will be given before any decision is made. There is no obligation to proceed.