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Scar revision

Keloid revision; Hypertrophic scar revision; Scar repair; Z-plasty

Scar revision is surgery to improve or reduce the appearance of scars. It also restores function, and corrects skin changes (disfigurement) caused by an injury, wound, poor healing, or previous surgery.

Images

Keloid above the ear
Keloid, pigmented
Keloid, on the foot
Keloid scar

Presentation

Scar revision - series

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Description

Scar tissue forms as skin heals after an injury (such as an accident) or surgery.

How much scarring there is depends on:

Depending on the extent of the surgery, scar revision can be done while you are awake (local anesthesia), sleeping (sedated), or deep asleep and pain-free (general anesthesia).

When to have scar revision done is not always clear. Scars shrink and become less noticeable as they age. You may be able to wait to have surgery until the scar lightens in color. This can be several months or even a year after the wound has healed. For some scars, it is best to have revision surgery 60 to 90 days after the scar matures. Each scar is different.

There are several ways to improve the appearance of scars:

Why the Procedure is Performed

Problems that may indicate a need for scar revision include:

Risks

Risks for anesthesia and surgery in general are:

Risks for scar revision surgery are:

Exposing the scar to too much sun may cause it to darken, which could interfere with future revision.

After the Procedure

For keloid revision, a pressure or elastic dressing may be placed over the area after the operation to prevent the keloid from coming back.

For other types of scar revision, a light dressing is applied. Stitches are usually removed after 3 to 4 days for the facial area, and after 5 to 7 days for incisions on other parts of the body.

When you return to normal activities and work depends on the type, degree, and location of the surgery. Most people can resume normal activities soon after surgery. Your doctor will likely tell you to avoid activities that stretch and may widen the new scar.

If you have long-term stiffening of the joint, you may need physical therapy after surgery.

Apply sunscreen to keep sunlight from permanently tanning the healing scar.


Related Information

Keloids
Contracture deformity

References

Hu MS, Zielins ER, Longaker MT, Lorenz HP. Scar prevention, treatment, and revision. In: Gurtner GC, Neligan PC, eds. Plastic Surgery, Volume 1: Principles. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 14.

Leitenberger JJ, Isenhath SN, Swanson NA, Lee KK. Scar revision. In: Robinson JK, Hanke CW, Siegel DM, Fratila A, Bhatia AC, Rohrer TE, eds. Surgery of the Skin: Procedural Dermatology. 3rd ed. Philadelphia, PA: Elsevier; 2015:chap 21.

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Review Date: 5/15/2019  

Reviewed By: Tang Ho, MD, Assistant Professor, Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology – Head and Neck Surgery, The University of Texas Medical School at Houston, Houston, TX. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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