“I wanted to comment today a little bit about scars and scar revision because it’s a commonly asked question and one that many patients are concerned about. They come in with long existing scars, many times they’ve been told there’s nothing they can do about the scar, or that the treatments are worse than the condition, and I’ll tell you that most scars I see can be address effectively and made to look better. We can’t completely erase scars. The body uses the scaring process as a part of wound healing that’s how the body puts or mends the skin back together. With that said, most scars can be improved in some very dramatically ways depending on the conditions that we’ll talk about.
First of all it’s important and understand what makes scars visible? What draws attention to the scars? And the first things, and these are not order of importance but really are all relevant is that depth of the scar. If the scar is relatively flat with the skin surface, that doesn’t cast shadows into the scar where a scar that’s deeper a pit, a hole, a crease or crevice, will have a natural ambient light which comes from overhead, a shadows cast into it that makes the scar look deeper or look more noticeable.
We can improve that by simply revising the scar and bringing those edges back to where they’re flat and there’s this technique that’s used to bring the edges initially to where they’re inverted or everted, and as they heal, they become nice and flat. So, a depression of scar or leveling with the skin is the first concept.
The color of the scar is very important, and this is really a common question people come in with. Typically scars heal lighter than the surrounding skin, irrespective of your skin type, and in some cases, scars can also hyper-pigment, which is a reaction to the inflammatory process called post inflammatory hyper-pigmentation or darkening.
Both the conditions of lighter than normal skin color and darker than normal skin color can be treated. It’s certainly easier to treat the darker than normal skin color with treatments like intense pulse light therapy or a number of other treatments that we can be used to lighten the post inflammatory, hyper-pigmentation or darkening.
If the scar is lighter than the surrounding skin, we really have to work to make sure that we’re addressing the third condition, and that’s the width of the scar. If the scar is more than a millimeter wide because it’s under tension or it was repaired non-optimally, we need to make sure the scars is narrow as it can be because is this scar is very narrow and still light, it’s going to be much less noticeable.
In general, if the scar is hyper-pigmented or lighter than the surrounding skin, we do a lot of things to disguise that scar, including the fourth thing, which is take the direction of the scar and move it in a direction that’s more favorable. A scar that travels across an important anatomic boundary like the nasolabial fold or vertically in the forehead is much better if we can change the direction of that scar and make it parallel to the lines of the forehead or parallel to the nasolabial fold or even in the fold in cases where we can move it in those directions.
In summary we talked about four things. One is the depth of the scar, one is the width of the scar, narrower than or wider than 1 millimeter or so really should be repaired. We’ve talked about the color of the scar being lighter or darker than the surrounding skin, and then lastly we’ve talked about the direction or shape of the scar.
Scars in general can be addressed by treating each or individually, one of those things that are causing its notice-ability. That’s really the key thing in disguising the scars. We can address those features that are applicable to the scar that you have, and address them in a way that makes it much less noticeable and do that in almost any scar that someone has a complaint or concern about. If it’s big enough to be noticeable or concerning to you, then its big enough for us to treat it and make it better.
If you have any other questions about scar revisions in general or the treatment of scars please don’t hesitate to visit my blog at DrMaas.com or even our website at MaasClinic.com and we’ll certainly welcome to submit photographs, videos if you want or ask questions on video and I’m happy to comment on them.
As always, I’m very happy to speak with you and give any answer as I can about the questions that you might have about plastic surgery in general or facial plastic surgery in particular. This is Corey S. Maas MDTM on Looking Your Best. “
