I have a appox. 3" scar on my right knee due to a broken patella surgery I had 2 and a half years ago. I am not sure what type of scar I have but I can describe it as flat loose wrinkly skin and is pretty much flush with my skin if not even a little bit sunken in. I've tried silcon sheets and bio-oil when it first healed. What are my options for improving the appearance of my scar? I'd like to consider a surgical procedure. Thanks
Doctor Answers 3
Knee Scar May Benefit From Scar Revision
You have a rather classic vertical knee scar that crosses the patellar area. It is actually exactly what you would expect from a scar that has two bad features; it is vertical and completely perpendicular to the relaxed skin tension lines of the leg and it is under near constant stress from the bending of the knee. It is likely as good as the scar can get given these features. No topical therapy will be of any benefit in this now mature scar. While the scar can certainly be revised by excision and closure, the important question is will it end up being better in the long run. It would be if the knee didn't move for a year after scar revision but that is obviously not possible. One should only consider scar revision of this type of scar if you can accept the risk that you may end up right back to where you started.
Improving Knee Scar
Regarding: "Knee Scar I have a appox. 3" scar on my right knee due to a broken patella surgery I had 2 and a half years ago. I am not sure what type of scar I have but I can describe it as flat loose wrinkly skin and is pretty much flush with my skin if not even a little bit sunken in. I've tried silcon sheets and bio-oil when it first healed. What are my options for improving the appearance of my scar? I'd like to consider a surgical procedure. Thanks"
The the appearance of your scar is due to multiple factors:
- the way the incision was placed (being able to place a scar in wrinkle lines is a better but not always available option)
- the location of the scar on an area which is pulled on (every time you bend your knee - sitting, kneeling etc)
- your ethnic background (darker skinned individuals = worse scars)
- the technique used to close the original incision.
There was NO choice in the first 3 factors. The last one is probably the least important but is not a negligible factor. With all due respect to our Orthopedic surgical colleagues, many of them do not put as much emphasis on wound closure as they do on repairing the underlying bones. More careful closure MAY result in better looking scars.
See a Plastic surgeon for a scar revision. The scar may be significantly improved but you may require splinting in the early recovery stage to avoid undue tension on the wound.
Dr. Peter Aldea
Surgical scarring and scar widening
This is a wide depressed scar cause by outward traction on the scar every time you bend your knee. The only way to solve this is to excise the scar and prevent outward traction until the scar has fully matured. Splinting the knee is impractical and in my experience scar taping does not work when the underlying scar goes through so much constant motion as it does over the patella. If you just cut the scar out and close the incision I can guarantee it will widen again. Sorry but we currently due not have a good option for this type of scar in this location.