Scar Revision

Many of you have had something done in the past where you've been left with an unsightly incision.  What kind of surgeries can cause unsightly face and neck scars?  Anterior neck surgery for protruding discs, carotid surgery, thyroidectomy, facial cyst removal and biopsies commonly cause them.  Obviously, facial trauma can also cause unsightly scars.  Unfortunately, many surgeons just don't understand how to prevent the ugly scar.  I've written about that previously.

So let's assume that you've got an unfortunate looking scar. What can you do about it?

If it's a fresh scar, start applying a silicone gel like Kelo-cote and keep it out of the sun.  No sun for 6 months minimum for my patients (that doesn't mean avoid it, but instead to keep the scar covered or with sunblock applied).

If it's a mature scar, you have several options.

CO2 laser resurfacing, done in increments 3-6 months apart, can help to fade the scar into the surrounding skin.  This works best for scars that are thin but pigmented, as it can make the skin around the scar more uniform in color.  If the scar is wide, I'm of the opinion that CO2 laser won't help to make the scar less noticeable.

Scar revision is the best option for the obvious scar.  Sometimes, all that is needed is for the scar to be excised and closed by a facial plastic surgeon. This can be done in instances when the scar is placed in an appropriate location (within the normal tension lines of the skin) but just didn't heal well.  However, if the scar is from trauma or simply poorly designed, the scar can be reexcised and broken up into an irregular pattern. Why? The human eye picks up straight lines far easier than it does a broken up line, so causing a linear scar to be more irregular makes it less noticeable.

Here's an example of what can be done to help break up an unsightly scar.

Once the scar has been excised, I then implement the same recommendations for any new scar, as the skin doesn't have memory, so it acts exactly like a new scar.

If needed to, we can then laser the new scar as it is healing, as early intervention with a laser can help fade it away.

Why such an emphasis on scars? Regardless of how good of a job I do inside the body, if the scar on the outside looks awful, the patient will consider that surgery unsatisfactory. At least, that's what I think when I see unsightly scars.  Let me know if you have questions about other options!