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Scars can be the result of trauma, prior surgery, or even a childhood injury. While no scar can be removed completely, plastic surgery can often improve the appearance of a scar by making it less obvious. How much the appearance of a scar bothers you is a personal matter. Dr. Hughes will examine the scar and discuss at length the treatment choices including the risk and benefit of each option. Whether it's revision surgery, steroid injections, laser treatments or dermabrasion, many scars can be improved dramatically with minimal downtime. If you are bothered by a scar, your first step should be to consult with a doctor regarding treatment options.

Scars can be the result from an injury or a previous surgical procedure. Proper facial plastic surgical principles will minimize scarring however healing, genetics, and certain medical conditions can result in less than optimal scars. Certain steps can be taken to improve bad scars and include silicone sheeting therapy, steroid injections, dermabrasion, and  laser treatments. However when these techniques are not enough surgical scar revision is required. Dr. Hughes has expert training in scar revision surgery. The latest techniques to improve scars include geometric broken line closures (GBLC), W-plasty, and Z-plasty. If you have a scar you are unhappy with and are considering revision surgery a consultation with Dr. Hughes will outline all of the available options and customize a treatment program that is best suited for you.

When is the best time to undergo scar revision?

Often patients are told to wait at least one year before considering scar revision. In many cases this may be good advice however in other cases this may not. Depending on the type of scar you have, early intervention can in some cases stop poor scar formation before it even occurs. Certain scars may improve dramatically with time however other types of scars may never get better no matter how long one waits. Steps which can be taken while in the ‘waiting period’ include; silicone sheeting therapy, steroid injections, and laser treatments. Depending on the type of scar, it may dictate when intervention is best taken. Many scars that appear unattractive at first may become less noticeable with time. Dr. Hughes will outline all of the available options and customize a treatment program that is best suited for you.

What is a hypertrophic scar?

A hypertrophic scar is often confused with a keloid scar. Both tend to be thick, raised and red. However hypertrophic scars remain within the boundaries of the original scar and typically will improve with time. Treatment options include waiting, steroid injections, silicone sheeting, laser treatments or scar revision surgery. Depending on the size and location of the scar, surgery may be performed in the office with local anesthesia or in the operating room under sedation anesthesia.

What is a keloid scar? 

Keloids are thick, hard, raised scars that tend to itch and in some cases hurt. The skin color can be red or darkened causing the appearance of the scar to be worse. Keloids can develop soon after surgery or in many cases months after the initial incident. Keloids can occur anywhere on the body but are more common on earlobes, shoulders and chest. They occur more commonly in darker skinned people, but can occur in any skin type. Keloids will grow outside the boundaries of the original scar, almost like a tumor.

Keloids are often treated with pressure, silicone sheeting and steroid injections. More radical treatments include surgery and in some cases radiation therapy. Keloids are stubborn and can recur, in some cases even larger than before. If you have a keloid and undergo treatment, this may require close observation for long periods of time so that if the keloid does recur it is treated properly early so that scarring is minimal.

What is a Z-plasty?

A Z-plasty is a type of scar revision surgery in which the direction of a scar is changed in order to camouflaged the scar or diminish a scar contracture. A scar contracture is a scar that is pulled in an unusual way causing an unnatural appearance to the scar. Contractures are often seen with burns or traumatic accidents, but can in some cases be the result of poor wound healing after surgery. A Z-plasty gives the scar a Z pattern appearance which in many cases can diminish the appearance of a straight line scar. Other types of procedures that are used in scar camouflage surgery include W-plasty, running W-plasty, multiple Z-plasties or Geometric broken line closure (GBLC).

What is a skin flap or graft?

In some cases the entire scar needs to be surgically removed. By removing the scar the surgeon then creates a new scar which need to be covered with normal skin. This can be accomplished by stretching nearby normal skin, a method known as a skin flap. Or the scar can be covered with new skin from another location, much like a patch, which is called a skin graft. Skin grafts are typically taken from more obscure locations so that the donor site scar is minimilized. Areas such as behind the ear or under the arm are often used. Skin graft donor sites are chosen based to best match the skin and are determined based on size, color, and location of the scar.