FAQ scars

Q. I’m 23. I must undergo an operation to have a cyst removed from my back but, as I have difficulties in healing, I fear that a keloid will appear. What do you advise me to do?
A. Unfortunately, the probability that a bad scar will appear does not depend on the surgeon’s ability, but on the way the patient’s skin tends to recover, as well as, to a lesser extent, upon the event that caused it to appear and on the precautions taken during the recovery.
The factors that influence the growth of a scar are many: in general, light-complexioned individuals are more likely to have good quality scars than dark-complexioned ones. Moreover, in certain areas of the body, such as the thoracic area, behind the ears and on the shoulders, the scars tend to be constitutionally more evident.

Q. I’m a 28-year-old girl. On my sternum appeared a small scar that, after some time, grew puffy and protruding and definitely unsightly. Is it possible to eliminate it by plastic surgery?
A. Scars are permanent marks which cannot be eliminated by any surgical technique but can only be improved.
Keloidal scars and hypetrophic scars can be improved both by medical and by surgical treatments (scar revision).
In any case, before going for scar revision, it is necessary to wait about one year after the event that caused the scar to appear, in order to allow the scar to take its definitive shape.
The surgical treatment of keloids, which usually comes after a series of attempts with medical treatment, allows for the so-called “intralesional” excision of the growth, that is without the complete removal of the same. Following such a technique, it was observed that the probability that an equally large keloid will re-form is lower, though still quite high.
The surgical treatment for hypertrophic scars, on the other hand, allows for the excision of the whole scar. However, even in this case the probability that a low quality scar will re-form is high, as the skin characteristics of the patient make all the difference in the onset of pathological scars.

Q. I’ve heard of a treatment called skin dermopigmentation which eliminates scars. What is it and how does it work?
A. Skin dermopigmentation is a treatment used in cosmetic surgery to pigment the skin and cover the scars, especially the ones that have grown after mastectomy and reductive mastoplasty operations. This treatment consists in making some sort of tattoo (pigmentation) on the skin (e.g. on the areola of the nipple) in order to cover the scars and reconstruct the areola removed by mastectomy.

Q. Are there surgical interventions that don’t leave scars?
A. No. Any kind of surgery necessarily causes scars. All surgical techniques try to hide the incision mark as much as possible (for example, in the skin folds, inside the nose, behind the ears, etc.), but the scar will always be there. It’s up to the surgeon to hide it and to make it as small and invisible as possible.