Some people naturally scar poorly. Some people are unlucky and have scars in bad locations or in unfavorable alignments. Time helps scars soften and fade, but after 6 months to a year, you pretty much know what you’ve got.
This type of procedure might be right for you if you've ever said:
“I’ve always had this ugly scar after my C-section.”
“It’s always been really thick and it’s itchy.”
“I hate the way it pulls on the skin around it.”
“It reminds me of the accident, and I don’t want to see it every day.”
Poor scars are usually from one of two causes: accidents causing bad lacerations or previous surgery. Most patients we see have had prior surgery that resulted in a poorly aligned or thickened scar. Sometimes they have horrible pain from scars pulling on underlying muscles and are brushed off by other doctors saying they have “chronic pain” or fibromyalgia, when in reality a scar can cause debilitating pain. Scar revision can be a life-changing procedure. The surgery typically takes less than an hour and if performed on an eligible patient can drastically improve or, in some cases, completely get rid of the pain.
The method
It’s important to look beyond just the scars involved on the skin and determine if it’s causing other problems aside from pain like pulling or decreased mobility. This helps to shape the surgical plan and can help us figure out our goals for scar improvement. If a scar crosses a joint like the elbow or is on the side of the neck then changing the shape of the scar can result in improved motion and decreased tightness.
You always trade one scar for another, but hopefully, it’s a good trade! We try to wait until a scar has fully matured before revising it, but some scars that are causing significant problems might be better to address early on instead of making you suffer for months.
The procedure
Scar revisions are almost always performed in the clinic with numbing medicine. The area is marked and numbed. All scar tissue is removed taking care to remove deeper aspects that cause pulling and tethering on muscles and skin. The incision is closed in layers to take tension off to prevent poor scar formation in the future. If you have keloid or hypertrophic scarring, you may benefit from an injection of steroids to keep the scar from becoming thickened in the future. For severe keloids, I recommend radiation therapy since it is shown to have the lowest risk of recurrence.