As a double board-certified plastic surgeon, Dr. Beaty not only performs cosmetic procedures such blepharoplasty and rhinoplasty, but he also performs various reconstruction procedures. Scar revision surgery is one of those reconstruction surgeries and it can really change the appearance of an ugly scar.
When considering whether you want to seek revision surgery, it helps to be familiar with the different types of scars. Here are descriptions of each type along with the usual methods Dr. Beaty uses to lessen their appearance.
Keloid scars are thick, puckered, itchy clusters of scar tissue that grow beyond the edges of the wound or incision. They are usually red or darker than the skin surrounding them. Keloids occur because the body continues to produce collagen, which is tough and fibrous, after the wound has healed. They are the most common on the shoulders, over the breastbone, and on the earlobes.
Dr. Beaty first treats keloid scars with steroid injected directly into the scar. If this doesn’t help, the scar tissue can be cut out and the wound resutured. A skin graft is normally used.
Hypertrophic scars are often confused with keloids because they both tend to be raised, thick, and red. But hypertrophic scars stay within the boundaries of the original incision or wound. Steroid applications or injections often improve the appearance of these scars.
If those conservative approaches aren’t working, Dr. Beaty will remove excess scar tissue surgically, and he may reposition the incision so that it heals in a less visible pattern. Steroid injections afterwards can prevent a thick scar from reforming.
Burns or other injuries resulting in the loss of a large area of skin may form a scar that pulls the edges of the skin together. This is called contraction and it may affect the adjacent muscles and tendons, restricting normal movement.
Correction of a contracture usually involves cutting out the scar and replacing it with a skin graft or a flap. Physical therapy may be needed afterwards to regain full function.
Facial scars, due to their location, are usually considered cosmetic. Dr. Beaty can improve their appearance usually by cutting out the scar and closing it back with tiny stitches, creating a thinner, less noticeable scar. Or, if the scar is near a natural crease, he may reposition it to align with the crease.