Scar revision

Scar Revision – When a Scar Can Be Made Less Noticeable

A scar is the body’s natural way of healing the skin after surgery, injury or other trauma. How a scar develops depends on factors such as its location, skin type, genetic tendency, tension in the skin and any complications during healing.

Scars go through a long maturation process. During the first few months, a scar may be red, firm, thickened or itchy. It usually then becomes gradually softer and lighter. Final maturation may take around 1 to 1½ years.

Scar revision may be relevant when a scar causes cosmetic or physical concerns, for example if it is wide, thickened, irregular, tight, painful or unfavourably positioned.

The aim is not to remove the scar completely – this is not possible – but to make it less noticeable, softer and better integrated with the surrounding skin.

The Consultation

During the consultation, the age, width, colour, thickness, position and direction of the scar are assessed, together with the quality of the surrounding skin.

It is also considered whether the scar is still maturing or whether treatment may be appropriate. Many scars improve naturally over time, and surgical revision is therefore generally considered only once the scar has had sufficient time to mature.

Which Treatments Can Be Used?

Treatment depends on the type of scar.

A thickened or active scar may be treated with silicone, tape or corticosteroid injections, which can help soften and flatten the scar.

Laser treatment or microneedling may, in selected cases, be used to improve redness, skin texture and the surface appearance of the scar.

If a scar is wide or cosmetically noticeable, surgical scar revision may be appropriate. The existing scar is removed and the skin is carefully closed again with the aim of creating a narrower and more regular scar.

For tight scars that restrict movement, a Z-plasty may be used. This changes the direction and length of the scar so that tension is distributed more effectively and the skin can move more freely.

How is Surgical Scar Revision Performed?

Smaller scar revisions can usually be performed under local anaesthesia.

The old scar is carefully removed, after which the skin is closed in several layers with as little tension as possible. The technique is adapted to the location and direction of the scar and to the natural lines of the skin.

A new scar will always form after surgery, but the aim is for this scar to become more discreet than the original scar over time.

Recovery

After surgical scar revision, mild swelling, tenderness and redness around the area may occur.

The scar then needs time to mature again. Silicone or tape may be used as part of the aftercare, and good sun protection is important because UV exposure can make scars more noticeable through changes in pigmentation.

Can All Scars Be Improved?

Not all scars are suitable for surgical revision, and the result depends on factors such as the location of the scar, skin type and the patient’s individual tendency to form scar tissue.

Some areas – including the chest, shoulders and ears – have a greater tendency to develop thickened scars.

It is therefore not possible to promise an invisible scar. The aim is an improvement in the scar’s shape, texture or position, making it less noticeable or reducing any physical discomfort it may cause.