A scar is a visible mark
of an injury or prior surgery. Although by definition a scar
is a permanent mark, it may be altered so that it no longer
appears unsightly. |
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Considering scar revision |
A scar can be modified
by various methods – surgical as well as non-surgical.
Surgical methods include – scar revision, dermabrasion,
excision with grafting (for hypopigmented or hypertrophic
scars) and tissue expansion.
Scar revision is the surgical alteration of a scar, i.e. replacement of an undesirable scar with a more pleasant
and favorable scar. |
Various factors determine
whether a scar is amenable to scar revision procedure. |
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Hereditary – intrinsic tendency to nasty scar formation. |
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Etiology – what caused the scar? |
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Site of scar – sternal and shoulder scars are notorious
to form nasty scars. |
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Alignment of scar – scar direction may be beneficial
or deleterious. |
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Nature of scar – healthy / stretched / depressed
/ atrophic / hypertrophic / keloidal. |
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Pigmentation – i.e. color of the scar. |
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Contracture – i.e. deformity of adjacent structures. |
These factors will be
discussed during your consultation and assessed during your
examination. |
| Scar Revision |
The procedure is generally
performed as a day care procedure. The procedure is commonly
done under local or regional anesthesia.
Once the area is completely numb (pain free) the scar is removed
and the resultant gap is closed either directly or after realigning
(changing the direction) the scar with a delicate surgical
technique leaving a less noticeable scar. |
| Post- operative course |
You will have a dressing
over the operated site for 2 to 5 days. Any pain or discomfort
will be minimized with adequate medication.
The decision to remove the stitches depends on the site of
the scar and the individual’s healing process. Initially,
the scar may appear red or brownish as well as swollen –
this settles over a few weeks. |
| Recovery |
After scar revision,
the new scar is immature i.e. not yet settled. Therefore,
it is very important to follow the instructions of cosmetic
surgeon to guide the scar to a more favourable outcome. Always
remember to handle the area gently - even when you are advised
to massage the area.
Exposure to sunlight can induce pigmentation (dark colour)
in an immature scar. Sunblocks / sunscreens may be prescribed
and should be used as instructed.
Some cases, physical barriers such as caps / umbrella etc
may be suggested.
Depending on individual cases, certain creams may be advised
to be massaged locally over the scar area for several weeks
to help smoothen and soften a scar.
Some special cases - depending on site of scar, tendency to
form thick, hard scars etc may be recommended adjuvants such
as -
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Steroid injections into the
new scar |
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Silicone sheets |
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Pressure garments |
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Laser |
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| Possible risks and complications |
You may have a detailed discussion about
this during your personal consultation. Some of the possible
complications include - anaesthesia related complications, swelling,
bleeding, infection, stretched of thickened scar etc. |
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This procedure is commonly used for
improving uneven pigmentation and scars on the face (e.g. Post-acne
scars). There are several methods for dermabrasion - microdermabrasion,
derma-roller, dermabrasion (manual or motorized burrs) or laser.
The procedure involves meticulous scraping of the superficial
layers of skin to a precise depth so as to ensure spontaneous
healing. The new skin that develops is fresher, firmer, more
evenly surfaced and pigmented.
Post-operative sun protection is vital. |
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Tiny, tit-bit lesions (tattoos, moles,
cysts etc) on the face and body can be a source of nuisance
and irritation. Such lesions can be aesthetically removed with
a well-placed innocuous and barely noticeable scar. |