Scar revision, acne, scarring, scars, keloid

A scar on the face can often affect a person's self-image as well as leave an indelible impression on those who see it. It often serves as a reminder to the patient of an accident or altercation. It should be understood that a scar is the body's way of healing the skin. Whenever all layers of the skin are divided the scar is nature's glue that allows the edges to be mended. Scars can fall into two categories, hypertrophic and keloid. A hypertrophic scar is often thick, red and often raised above the skin level. The keloid is similar to the hypertrophic scar except that it extends beyond the skin edges.

Several characteristics of scars allow them to be more conspicuous. These include the width, length, colour, and orientation to the natural lines of the face. Close approximation to structures such as the eyes and mouth, the skin type and whether the scar is elevated or depressed are also characteristics that may play a role in making them more noticeable. The goal of scar revision is to replace a scar with a less noticeable one. This may require multiple procedures to obtain a pleasing result. Dermabrasion frequently provides the finishing touch to scar revision. Consistent with all facial plastic procedures the goal of scar revision is improvement and not perfection.

When is the best time to undergo scar revision?
Scars go through a maturation process which can last anywhere from six to 18 months. It is best to wait six months to a year after a scar forms before attempting surgical correction. It may be appropriate to correct some scars earlier and this will be discussed during the consultation.

Can anything be done to a scar other than surgery?
If a scar is raised and reddened it can be injected with a steroid which will help to flatten the scar as well as improve the redness. Steroids do not make wide scars thinner. Surgery can improve a wide scar.

What can I expect immediately after the surgery?
The incision will usually be taped for at least one to two weeks to take tension off the surrounding skin. It may be necessary to continue to tape the incision intermittently after this time. This will prevent the scar from widening. After the surgery the scar may develop some redness and lumpiness. This will settle with time to form a thin white line. The redness and lumpiness can also be treated with steroid injections. Remember that the final result may take more than one procedure.

What can be done for the "ice pick" scars?
This usually results from acne and can be very distressing to the patient. Punch Excision may be used to treat these scars. It may be necessary to perform dermabrasion after the healing.

What are the risks of surgery?
There is risk involved with any surgical procedure, however, the risks of facial surgery are minimal. The risks include bleeding, infection and persistent scarring. These are usually rare complications and will be discussed during your consultation as well as ways to avoid them.