Scars 101

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Scars 101- read this before you email me about removing your scar.

It is a common misperception that scars can be removed.  They cannot.  Scars can only be revised and scar revision only makes sense if it is likely that the revised scar will look better than the scar it replaces.  A "good" scar that resulted from a well repaired surgical incision and healed without complications probably won't look much different after a revision.  "Bad" scars, however, may benefit from surgical revision.

Reasons for “bad scars” include:

  • Delayed healing for any reason.
  • Infection and/or irritation while healing.
  • Dehiscence (fancy word for the stitches failing and the wound falling apart).
  • Exposure to sunlight during early healing.

In these cases, excising the old scar and replacing it with a clean, fresh suture line that has a chance to heal without any of the above issues is likely worth a try. 

Other scar conditions that usually can be helped with surgery include:

  • A scar with a "divot" or a scar that is tethered to a deeper structure.
  • A scar that is aligned unfavorably with the natural tension lines of the skin.
  • Scars that overlay an area of fat atrophy such as bad acne scarring.

Scar revision can usually smooth out, fill out or reorient these scars so they are less obvious.

Scars that are usually not improved with further surgery include:

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  •  Multiple, smooth hairline scars such as scars from “cutting”.
  • Scars that are still pink and raised.They need more time.
  • Scars that are in areas of high skin tension and movement. 
  • Well healed burn scars that are flat or have been skin grafted.
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    Non-surgical treatments such as bleaching cream, steroid injections, laser treatment, pressure dressings or even camouflage tattooing may help with these types of scars but surgical revision is not likely to result in much on an improvement. 

     

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Article by
Seattle Plastic Surgeon