Scars are the visible signs left on the skin once a wound or incision has healed. Scars can be flat, depressed or raised, and while many are “skin coloured” some may be lighter or darker than the surrounding skin. The type of injury, poor healing, picking, and location of the scar can all affect the appearance of a scar. Patients seeking to improve the appearance of their scars can rely on the technical and aesthetic skill of Dr. Barr. Plastic surgery for scars can help diminish the appearance of most scars and reduce the mental discomfort they cause. The following article will explore different types of scars, various methods of scar removal, and how to remove old scars versus how to care for newer scars.
Types of Scars
There are multiple types of scars, each with their own unique characteristics.
Keloid scars
These are thick, raised , firm scars that appear at the site of a “wound” or injury. They are not confined to the initial injury but expand larger than the injury zone. They often appear red or darker in color, as compared to the surrounding normal skin. Keloid scars are formed because the body generates excessive collagen as the wound is healing. These scars may appear anywhere on the body, but are more commonly located on the chest, back, shoulders, and earlobes. They occur in all skin types but more often in darker-skinned people. Keloid scars may occur up to1year after the original trauma to the skin.
Hypertrophic scars
Hypertrophic scars are similar to keloid scars, except for the fact that their growth is confined within the boundaries of the original incision, wound or injury. These scars may look red initially but then become “skin coloured”. They are thick and raised. Hypertrophic scars usually start to develop within the weeks following injury to the skin. Hypertrophic scars may improve naturally, and tend to become smaller and less noticeable over time but they do not completely flatten out. They can be improved with early non surgical interventions such as pressure, massage, silicone gel / sheeting and IPL treatments.
Atrophic scars
Atrophic scars appear as sunken, indentations in the skin. They look like exaggerated stretch marks. People can get these from trauma, surgery or severe acne or chickenpox. Once they are formed, the size and shape of atrophic scars do not usually change with time.
The scarring related to acne can be classified as one of three types:
- Ice pick scars. These scars are small, narrow, and deep, creating a pitted appearance.
- Boxcar scars. Boxcar are wider and shallower than ice pick scars and have clearly defined borders.
- Rolling scars are typically shallow and wide but they do not have distinct edges.
Surgical Scar Revision Methods
Can plastic surgery remove scars?
Dr. Barr may employ a number of different scar revision techniques based on the nature of the scar, its cause, location, size; and the unique characteristics of your skin. The best method of plastic surgery for scars for your particular case will be detailed for you during your consultation with Dr. Barr.
These may include:
Surgical Excisionfor deep scars. During this operation to remove scar tissue the scar is shaved down and scar tissue is surgically removed to reduce the size of the scar. By excision of the scar, the larger depressions can be eliminated causing the skin to be smooth. Surgical revision of a scar will often change the orientation of the scar into a natural crease or use Z plasties to make the scar less conspicuous.
Surgical Subcisionis used in areas of multiple moderately depressed scars. With this method, the fibrous bands that tether the scar to the underlying tissue and cause the depressions are broken up. The release of the fibrous bands helps lift the tissue back up. In addition to subcision, Dr. Barr may recommend placing an injectable under the scar to tighten the overlying skin.
TCA Treatment or Renuvion / J Plasma resurfacing of Ice Pick Scarsmay be done to minimize the appearance, size, and depth of ice pick scars. TCA treatment creates a chemical reaction using tricholoroacetic acid (TCA) that leads to the formation of new collagen fibers. This increase in collagen production helps thicken the skin to reduce the appearance of the scars. The Renuvion technology elevates the skin and is the most effective at tightening the skin and minimizing the scars.
Old Scars Vs New Scars
A common question asked by patients is how to minimize old scars. It takes a year for all incisions or scars to fully mature. During the initial 8 months, massage, pressure and silicone will significantly improve the outcome of the scar. Since scars improve with time, scar revision surgery is usually not considered for approximately one year. During this time scars tend to shrink or fade on their own. Past the one year mark, a consultation can be organized to determine the best method of scar revision surgery.
Benefits of Scar Revision
Patients often pursue scar revision surgery to:
- Improve or eliminate the appearance of scars
- Help put past injuries or trauma behind them
- Feel more comfortable in their own skin
- Increase self-confidence
Frequently Asked Questions
Is it possible to remove a tummy tuck scar?
Dr. Barr takes every precaution to ensure his tummy tuck patients experience minimal scarring. His placement of the tummy tuck incision is so low that patients can wear revealing swim suits and thongs without their incisions being visible. Dr. Barr manages the tension on all his surgical incisions to minimize the appearance of the incisions. The team at Barr Plastic Surgery instruct patients on how to optimize the appearance of their incisions, and offer reusable silicone strips and/or medical grade topical scar cream to further facilitate this. For individuals who have had surgery elsewhere and experienced significant scarring, tummy tuck scar revision may be possible. In order to determine the best method of revision you would need to be seen in consultation.
How much does facial scar revision surgery cost?
The cost of scar revision will be based on the revision method suited to your particular case. During consultation you will be advised of the best treatment option and provided with an accurate quote.
Scar Revision at Barr Plastic Surgery
The first step when considering scar revision surgery is to schedule your consultation with Dr. Barr. The consultation process enables Dr. Barr to properly assess you and determine whether you are a suitable candidate for scar revision surgery. It also provides an opportunity for you to obtain important information about the procedure and to have all of your questions answered prior to proceeding with scar revision surgery.