A scar excision procedure is typically performed in the office under local anesthesia, so you won’t feel anything. “If the scar is, say, next to the eye and the patient is very scared or anxious, I’ll give them IV sedation,” says Dr. Ostad. In situations where the scar covers a large area of skin, your surgeon may recommend general anesthesia.
Your surgeon’s technique will also depend on the type of scar that’s being removed.
In many cases, a linear section of scar tissue is excised, and the surrounding skin is neatly sutured closed.
Another common scar revision technique, Z-plasty, can change the direction of a scar. The old scar is removed, and incisions are made on the side of the wound to create flaps, which are then rearranged to create a “Z” pattern. “By converting a scar into a zigzag line—or, in the case of a W-plasty, continuous Ws—you create irregular lines that make the scar less visible,” explains Dr. Ostad.
These incisional patterns also reposition the scar so it becomes parallel to “relaxed skin tension lines,” the natural direction of the collagen fibers in the skin. “When placed in that vector, scars generally heal much nicer,” says Dr. Ostad. This technique also improves flexibility.
Once the scar is revised, the surgeon typically performs a layered closure by placing sutures both down in the dermis and in the more superficial tissue. This helps relieve tension on the incision and prevent the scar from widening.
In a part of the body that moves a lot (like the shoulder or the back), your surgeon may also tape the incision to help support it. “This can reduce micromotions of the tissues, so the incision can heal earlier,” says Dr. Daniel Barrett, a plastic surgeon in Beverly Hills, California.
RealSelf Tip: To improve the healing of your new scar, stop herbal supplements and medication that can increase bleeding for at least 3 days before your scar removal surgery.
