Facial Scar Revision Surgery

The skin, when undergoing recovering from injury will scar through multiple layers of the skin depending on the severity of injury. These injuries can include accidental trauma, surgery, burns or acne.  Once a scar forms, it is permanent but may be less visible or relocated surgically.

Most are self-conscious and embarrassed about facial scars. Some people may experience diminished function of the eyes, mouth or nose due to scarring. Facial scar revision could improve your appearance, self confidence or your level of facial function.

A successful plastic surgery begins with good rapport between patient and surgeon. Trust, based on realistic expectations and specific medical expertise, develops during the consultation stages before surgery is performed.  Your surgeon can answer specific questions about your specific needs.

Am I a Candidate for Facial Scar Revision?

A basic requirement for surgery is good health. Other requirements are subtle and need to be further discussed with your surgeon.  It is important that your expectations following facial scar revision are realistic and discussed with your physician. A person considering facial scar revision must understand that complete removal of a scar is impossible; the goal of facial scar revision is to improve the appearance of the scar by disguising it, relocating it, or minimizing its prominence.  Skin color/type, age, and type of scarring are all important factors that much be part of the consultation prior to surgery.

Different types of scars respond to different plastic surgery techniques, allowing your surgeon to use his/her knowledge of these techniques will promote optimal results. Timing of surgery is another important factor. Some surgeons advise against any scar revision in cases of injury for up to a year following the injury.

How do I Decide Whether or not Facial Scar Revision is For Me?

Whether you decide on having facial scar revision for cosmetic or functional reasons, your choice of facial plastic surgeon is of paramount importance.  Your surgeon will examine the scar along with a detailed history in order to decide on the proper individual treatment. Your surgeon will then explain possible outcomes expected from your facial scar revision surgery.

Different scars require specific treatments.  An example being severe burns that destroy large sections of skin, causing the skin to heal in a puckered way. As the skin heals, muscles and tendons may be affected in this ‘contracting’ movement. Keloid scars are the result of the skin’s overproduction of collagen during wound healing. These scars generally look like growths in the scar site. Hypertrophic scars, unlike keloids, do not grow out of the boundaries of the scar area, but because of their thick, raised texture, can be unsightly and restrict natural movement of the underlying muscles and tendons.

Scars located on the face are unattractive simply because of where they appear on the face, some scars may affect the movement of facial expressions. All surgical possibilities will be discussed amongst the facial plastic surgeon and patient during the initial consultation. Risks involved with each individual type of scar will also be discussed during the pre-operative consultation. Surgical outcomes and expectations between you and your surgeon must me mutually discussed and agreed upon prior to surgery.

Because scars are highly individualistic and the patient’s attitude toward the scars are personal, facial scars may require more than one procedure to reach desired results.

How is Facial Scar Revision Performed?

When a contracture scar is involved during the surgery, complete removal of the scar is usually the best method. Skin flaps, composed of healthy, unscarred skin are then lifted and moved to form a new incision line. If a flap is not a possibility a skin graft may be used. A graft involves taking a section of skin tissue from one area and attaching it to another area. Time must be allow following surgery for new blood vessels and soft underlying tissue to form.

Z-plasty is a method to move a scar from one area to another, usually creating a new natural fold or crease in the skin. Z-plasty does not remove all signs of the scar, it makes it less noticeable.

Dermabrasion and laser resurfacing are options available to plastic surgeons to make “rough or elevated” scars less noticeable. This is done by removing part of the upper layers of skin with an abrading tool or laser. Clearly, the scar will remain, but will appear smoother and less visible.

Keloid or hypertropic scars are often treated first with steroid injections to reduce size and swelling. If this is not necessary, these scars can be removed surgically, incisions closed with fine stitches, often resulting in less noticeable scars.

Expectations Following Facial Scar Revision

Discomfort is to be expected following facial scar revision surgery. Swelling, bruising and redness are non-avoidable. It is important to follow your surgeon’s post-operative recommendations to ensure the healing process doesn’t interfere with your surgery. Sutures are usually removed within days after the surgery. Your skin requires additional time following suture removal to heal. Decreased activity after surgery, keeping your head elevated when laying down, cold compresses to reduce swelling and avoid activity that would place stress in area of incision are all important factors to healthy healing. Medications should be avoided without consulting your surgeon. 

*It is important to remember that scar tissues require at least a year or more to fully heal and achieve maximum results. Facial plastic surgery makes it possible to correct facial flaws that can undermine self-confidence.  Changing a scars appearance can help you change your attitude about your appearance.