Scar Revision

Any deep wound of the skin results in a scar. A scar is simply the result of the body’s normal healing response to an injury, whether it is traumatic (accident) or elective (surgery). Some wounds heal with fine imperceptible scars; others with thick, painful, unattractive ones.

Scar revision surgery is designed to improve the appearance, symptoms or problems created by a less than ideal scar. There are a variety of scar revision procedures that can be considered to help bring about this improvement. Most involve the excision of the offending site with a closure that can employ one or more of a variety of techniques. The procedure may yield a scar that is less perceptible but it cannot magically erase it without leaving a trace.

Postoperative care is also important in attempting to obtain the best possible scar. Topical agents such as silicone gel sheeting and Mederma® can be helpful in this regard. It is also important to protect the site from significant sun exposure for at least several months. Regular application of a high SPF broad spectrum sunscreen is recommended.

Keloids

Keloids are a special type of scar that are aesthetically displeasing, often difficult to treat and can be associated with symptoms such as pain, burning, itching and stiffness. They are elevated above the surrounding skin, extend beyond the original margins of a wound or surgery site, do not regress spontaneously with time, are very firm and have a high rate of recurrence. They should not be confused with run of the mill wide but flat scars or slightly elevated ones that are thick (hypertrophic scars).

Keloid of earlobe

Keloid of shoulder

There are several common risk factors that predispose individuals to develop keloids but their formation is not inevitable. Conversely though less frequently, some people can form them who seemingly don’t have any clear cut predisposition. Who are those at greater risk? Individuals who are dark complected (especially Blacks), are less than 30 years old, have/had burns or ear piercings, and surgery or skin injuries to the sternum, upper arms and shoulders.

A variety of modalities and approaches have been employed for the treatment of keloids including surgical excision, steroid injections, pressure dressings, topical silicone gel sheeting, pulsed dye laser, radiation treatments and intralesional injections of chemotherapy agents. Combination therapy often will lead to better results with a lower risk of long term recurrence. Unless the growth is very small, my typical recommendation is for surgical excision along with repeated injections of a low dose steroid in the area and close monitoring over 1 – 2 years. Topical silicone gel strips are often used in conjunction for improved outcomes.

Experience the Benefits of Facial Skin Rejuvenation

If you are seeking smoother and healthier skin, the scar treatments offered at our practice may be right for you. Schedule a consultation with Dr. Turkeltaub to find out which treatments are best for your needs.