Scar Revision

Every time the skin and underlying tissue is cut or damaged, the body heals itself but you are left with a scar, both inside and out.

Scars can range from acne, burns, a cut or surgical incisions. The latter should be a controlled scar and a surgeon will do their best to make the scar as aesthetic as possible. However, your skin colour or type, your age and your lifestyle (smoking in particular) can all impact on how well you scar.

Scars: Am I suitable?

If you have noticeable scars that is affecting your confidence then it might be worth consulting with a cosmetic doctor or surgeon to see if the appearance of the scars can be improved. What is essential is that you realise that this might just be replacing one scar with another scar.

There are several different types of scarring:

Atrophic scars – this is a sunken or pitted scar, which you may be left with after acne or chickenpox. Contracture scar – this type of scar causes the skin to tighten and might affect movement in that area. This might be the result of a burn.

Hypertrophic scars – a red, raised scar which you may get after surgery but which should fade over the years. Keloid scars – a red, raised scar that may also be painful and itchy and affect the skin and tissue surrounding the scar. These often don’t fade in the way that hypertrophic scars do.

Stretch marks – this scarring affects the skin alone and is a result of the skin stretching rapidly. It can be caused by weight gain, pregnancy and can even affect teenagers who go through a growth spurt.

Scars: What do I have to do to prepare?

Your practitioner will be able to give you more information on how to prepare. It might be a case of waiting as it is often better for a scar to mature before it is treated.

Scars: What’s the treatment like?

Scar revision treatment is not scar removal and treatments are aimed at improving the appearance. They range from creams to surgery:

Topical treatments; there are some creams and gels on the market that claim to fade scars, but their effectiveness is disputed. Silicone gel treatments do have a better claim to success but this can be quite a lengthy treatment option.

Steroids; a steroid cream or a steroid injection can be used to help soften and shrink scar tissue.

Skin rejuvenating treatments; these all aim, with different methods, to remove the surface layer of the skin and stimulate new tissue grown. The new skin is hopefully softer and less obviously scarred. These treatments include IPL, laser, skin peels, microdermabrasion, dermaroller.

These are more suited to mild scarring and it is important to be aware that some of these treatments can cause pigment changes in the skin, particularly in darker-skinned patients, so it might cause more problems than it solves. See the individual treatments for more information.

Scar revision surgery; the aim of this surgical procedure is to improve the appearance of scar. This might be a case of changing the direction of a scar so that it lies in a natural skin crease or along a facial contour. Keloid scars are treated by cutting out the material in the scar, usually hard fibrous collagen, and then the skin is sewn back together. With hypertrophic scars, the surgeon will remove any excess scar tissue and may reposition the scar.

Contracture scars can affect mobility and scar revision surgery can also relive that by using local flaps of healthy skin to break up the contractures or tight band that form. Skin grafts from elsewhere on the body can also be used.

Scars: What about after?

Massage of the scars and the use of silicone gel pads can often produce a reduced healing time. It is also possible to investigate cosmetic camouflage techniques.

Scars: Are there any risks or side effects?

There are minimal risks to scar revision surgery, bar that the scar may re-occur after treatment and be even worse than before or that you may not be satisfied with the appearance of your revised scar.

Scars: What will it cost me?

See the individual treatments for more information. Scar revision surgery will cost from £500.