Scar reduction
What is a scar?A scar is the tissue that fills the wounds and the lost matter of tissues and organs. Indeed, the scar tissue forms every time a solution of continuity occurs in the skin (epidermis and dermis) as a consequence of a pathological or traumatic event.
Are there different kinds of scars?There are essentially two kinds of pathological scars: keloids and hypertrophic scars.
What influences the quality of a scar?The quality of a scar, whether resulting from traumatic events or from surgery, depends mainly upon the way the skin of the individual tends to recover and, to a lesser extent, upon the kind of event that caused it to form and on the precautions taken during the recovery period.The factors that influence the growth of a scar are numerous: in general, light-complexioned individuals are more likely to have good quality scars than dark-complexioned (Mediterranean) ones. Moreover, in certain areas of the body, scars tend to be more evident by nature, such as in the thoracic area, behind the ears and on the shoulders. However, there are situations in which the probability of growth of a bad scar is not dependent on the characteristics of the individual; this happens with the scars resulting from deep-second or third degree burns or from complex traumas.
Is it possible to remove scars?Unlike what many people think, scars are permanent marks that cannot be eliminated by any surgical technique: they can only be improved.
What kind of treatment can be used to improve scars?Keloidal and hypertrophic scars can be improved both through medical treatment and surgical treatment.Before resorting to surgery for scar revision, it is normally advisable to consider all the other possible medical treatments aiming at improving the appearance of the scars, especially if these are not so evident, because surgery might produce little result. Anyhow, before resorting to surgery it is necessary to wait about one year after the event that caused the scar to form. During this period, indeed, the scar goes through many transformations which make it evident especially in the first three months, till it maturates and takes its definitive shape.
What medical and surgical treatments are used to correct scars?The medical treatments of a scar are the following:
We place great hopes of improvement in a new surgical technique which uses autologous tissue (one's own cells) called Recell. The surgical options must be discussed exhaustively with the patient, who should know everything about his improvement expectations.
What surgical treatments are indicated for keloidal and hypertrophic scars?The surgical treatments for scars vary depending on the type of the scar (keloidal or hypertrophic scar).The surgical treatment of a keloid, which usually comes after a series of attempts with medical treatment, allows for the so-called "intralesional" excision of the keloid, that is without the complete removal of the same. Applying such a technique, it was observed that the probability that an equally large keloid will reform is lower, though still rather 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 reform is high, because the skin characteristics of the single patient make all the difference in the onset of pathological scars.
What happens during the pre-operative examination?The surgical treatment of scars is a very customized operation which, as such, requires an accurate specialist examination.During the first examination, the surgeon will assess the quality and the size of the scar and show you the cosmetic result which is actually possible to achieve. The surgeon will also assess your physical condition in order to exclude the presence of troubles (such as clotting or healing disorders, high blood pressure, etc.) which might affect the final result of the operation. At the end of the examination, the surgeon, in tune with you, will choose the surgical procedure most suitable for your situation. Before the operation you will receive specific information about the preoperative and postoperative diet and the use of drugs, alcohol and cigarettes.
What kind of anaesthetic is given?Scar revision is normally performed under local anaesthesia and in outpatient care, and its length varies depending on the kind of scar to be treated.
What happens during the post-operative period?To achieve as good as possible results, it is essential that, after scar revision, you keep strictly to the instructions the surgeon will give you from time to time.During the post-operative period, you are advised to use medical aids on the new scar while it is developing, in order to minimize the probability that a bad quality scar will form. The specialist will show you the procedure and timing of such treatments during the follow-up visits. Your normal activity will be resumed depending on the kind of operation you have undergone. For simple revisions of small scars performed under local anaesthetic, it is usually possible to resume one's daily activities as early as the day after the operation.
What kind of result can be achieved by scar revision?The cosmetic result varies depending on the reaction of the individual and is influenced by several factors (the type of complexion, the area of the body, etc.).The result is permanent and will be achieved definitively about one year after the operation. If you wish to take this subject further, we advise you to visit the FAQ page about scar reduction, where you will find the answers to the most frequent questions asked by the patients. |
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Chirurgia-plastica-estetica.it Prof. Mario Dini Chairman and Director of Plastic Surgery Dept. - University of Florence |
