How to Correct a Z Plasty That is Contracting and Forming Keloids?

Had a vertical anterior incision for a cervical fusion and the incision contracted and formed a keloid in places along the incison. I had a z plasty and to much displeasure, it has contracted and formed keloids in several places. I had z plasty revised and at that time 5fu was used prior to suturing. The second revision is now contracting and I am in pain. I need some advice. What is the next step. I look like a cougar attacked me. Please send me some good advice.

Doctor Answers 1

Scar Contractures and Zplasty

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There is a reason that vertical scars are fairly uncommon on the neck and the abdomen as they frequently form scar contractures which can cause functional problems as well as their obvious cosmetic appearance.  Zplasty is a common way to treat scar contractures by breaking up the straight line and effectively making the scar longer. For the sake of argument we will assume your scars are actually hypertrophic rather than true keloids. There are several reasons why the hypertrophic scars recur after Zplasty. Commonly the Zplasty is poorly designed where a single Zplasty was used rather than multiple continuous Zplasties which keep the limbs shorter but provide more lengthening to the scar. The second reason is poor healing of the tips of the Zplasty flaps leading to recurrent scarring. Regardless there is no reason why improvement of the contracture cannot be achieved by a fully trained Plastic Surgeon.

Hoover Plastic Surgeon

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