Scar revision is plastic surgery performed to improve the condition or appearance of a scar anywhere on your body. It is important to remember that any wound, repaired laceration or closure of a surgical incision results in a scar. The difference is that in most cases the scar heals so that it is concealed or difficult to perceive over time. An abnormal healing process can affect the quality of the scar making it more noticeable.

TYPES OF SCARS

• Discoloration/Irregular surface

•	no impairment of function
•	does not cause physical discomfort
•	examples; acne scars , scars from minor injury and prior surgical incisions.

• Hypertropic scars

•	cluster of scar tissue that develops directly at a wound site.
•	thick, raised, red and/or uncomfortable
•	may become wider over time.
•	can be hyperpigmented (darker in color) or hypopigmented (lighter in color).

• Keloids

•	larger than hypertropic scars.
•	can be painful or itchy
•	extend beyond the edges of an original wound or incision.
•	can occur anywhere on your body, especially on the face, neck, ears, chest or shoulders

• Contractures

•	scars that restrict movement
•	occur when there is a large amount of tissue loss, such as after a burn.
•	Contractures also can form where a wound crosses a joint, restricting movement of the fingers, elbows, knees or neck.

The type of scar you have will determine the appropriate techniques your plastic surgeon will use to improve your scar.

WHAT TO EXPECT DURING YOUR CONSULTATION
Dr. Stephenson will evaluate your overall health and more specifically evaluate your scar and its quality. He will also review your medical history and any previous treatment of the scar. During the consultation, Dr. Stephenson encourages you to ask questions pertaining to the proposed treatment of your scar. This will help Dr. Stephenson understand your goals/expectations and whether these expectations can be realistically achieved.

SCAR REVISION SURGERY
The degree of improvement that can be achieved with scar revision will depend on the severity of your scarring, and the type, size and location of the scar. In some cases, a single technique may provide significant improvement. However, Dr. Stephenson may recommend a combination of scar revision techniques to achieve the best results. Scar revision may include:

• Topical treatments,

• Example include gels, tapes or external compression

• Injectable treatments

• used to fill depressed or concave scars
• can be steroidal-based compounds

• Surface treatments

•	These methods can soften surface irregularities and reduce uneven pigmentation.

•	Dermabrasion is a mechanical polishing of the skin.
•	Laser or light therapy allows new, healthy skin to form at the scar site.
•	Chemical peel solutions soften irregularities in texture and color.
•	Skin bleaching agents are medications applied topically to lighten the skin

• Surgically incision

•	used in deeper scars
•	requires layered closure.
•	may require complex flap closure to reposition a scar or improve flexibility of a contracture

• Pharmaceutical tissue substitutes

•	used if ample healthy tissue is not present
•	more likely with revision of severe burn scars

• Tissue expansion

•	an inflatable balloon is placed under the skin near the scar site
•	over time, the balloon is filled with sterile solution to expand the area of healthy skin.
•	Once the skin has been stretched sufficiently, the expander and the scar are removed and the stretched skin is moved to replace the scar tissue

SCAR REVISION RECOVERY
At the completion of your revision procedure, you will be placed in a surgical dressing. Sometimes a small, thin tube may be temporarily placed under the skin to drain any excess blood or fluid. This tube will be removed early in the healing process. You will be given specific wound care instructions in order to allow for the best possible healing and outcome. Swelling and bruising are expected after scar revision. The swelling and bruising will start to resolve about a week after surgery, although this will vary between patients.

Following your surgery you may be instructed to apply topical treatments. You will at a point during the healing process be instructed to apply sunscreen to minimize darkening of the scar revision. The scar revision will take time to improve. This may take up to one year before the final result is evident.

SCAR REVISION CREDENTIALS
Credentials matter. Dr. Stephenson is certified by American Board of Plastic Surgery. This is the only medical specialty board for aesthetic and reconstructive plastic surgery recognized by the American Board of Medical Specialties (ABMS).

Dr. Stephenson will be happy to discuss how a scar revision may be beneficial to you.† To schedule a consultation with Dr. Stephenson at Signature Plastic Surgery, call (770) 466-4700.