Although scars form as a natural part of the healing process your body uses to repair and close wounds, they’re often an unwelcome reminder of a previous injury or surgical procedure. Many scars are removed for cosmetic reasons, but some require treatment because they interfere with range of motion, such as a large burn scar over your elbow, knee, or fingers.
Dr. Scott deVilleneuve is a talented, board-certified surgeon who specializes in soft tissue surgery, including scar removal (revision). He’s happy to answer a few questions about scar types and the treatments available for minimizing their appearance.
The depth, location, and nature of a skin wound often influences the appearance of a scar.
Whenever your skin is damaged, your body stimulates the production of collagen and other natural substances that form new tissue to repair the gap left by the wound. This new skin has a different texture and color than the older skin and may form a ridge or a bump over the wound site, which makes the scar more visible.
Sometimes a dimple or pit forms when the underlying support structure is damaged or lost. This is noted with acne, but also occurs with other wounds, including previous surgical incisions. Skin discoloration remaining after acne outbreaks is also a form of scarring.
Other more noticeable scars include:
It sometimes surprises our patients to learn that the best treatment for removing a scar requires making a new one.
The goal with the new scar, however, is to use a surgical approach and closure technique that leaves minimal, often nearly invisible, scarring. We combine that with various topical therapies that help promote healing and reduce scarring risk following the revision procedure.
The surgical approach for scar revision varies according to the characteristics of the original scar. Following an incision to remove the old scar, for instance, I may recommend a flap closure that repositions the scar so that it’s less noticeable. Other methods may include skin grafting to replace large areas of damaged tissue or a layered closure that repairs the subdermal layers as well as the surface skin.
Topical treatments that speed healing and help reduce irregularities in your skin’s texture and coloration include gels, collagen strips, and external compression. I may also recommend injections with steroid-based substances to reduce collagen formation and help prevent keloid formation or dermal fillers for concave scars.
If your scar is less than a year old, it’s also possible we can help minimize its appearance with topical therapies or injections
We’ll have a long discussion about expectations and aftercare before scheduling your procedure. However, like any surgery, scar revision typically causes localized discomfort and swelling at the incision site for one to two weeks.
The new scar will continue to heal and fade for up to a year, however, and it’s important that you follow aftercare instructions carefully as this will minimize scarring at the new incision site.
We can’t remove a scar entirely, but we can often greatly decrease its appearance, sometimes so significantly that you must search carefully to find it. In the case of contracture scars, surgical revision and appropriate wound care afterward can help restore both appearance and function to the region.