Plastic Surgery: Scars
An unsightly scar can make you feel self-conscious as well as limit your mobility and function depending on where the scar is at. While no scar can be removed completely, the plastic surgeons at The Centre, P.C. can often greatly improve the appearance of the scar. Our specialized staff of therapists in our rehabilitation center, The Centre for Working Hands, can help you to regain mobility and function of the scarred area by way of many cutting edge therapeutic treatments.
Many times, scar revision treatments are covered by insurance especially if the treatment will help restore function or increase mobility. The specialized plastic surgery staff at The Centre, P.C. will be able to help you determine if your insurance will cover scar treatment for you.
There a many types of scars and some are more common than others. For example, keloid scars are thick, large, and raised irregular scar tissue. They grow behind the edges of a wound or incision and are often red or darker in color than the surrounding skin. Keloid scars are formed when the body continues to produce collagen, a tough, fibrous protein, after the wound has healed.
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Keloid scars can be treated with steroid injections rather than surgery. The steroid injections will reduce redness, itching and burning, and sometimes even shrink the scar. Although they can appear anywhere on the body, keloid scars are most often found on the breastbone, earlobes, and shoulders.
Similar to keloid scars, hypertrophic scars are thick, red, and raised. Hypertrophic scars differ from keloid scars in that hypertrophic scars remain within the boundaries of the wound or incision. Steroid injections may help, but surgery may be necessary. Your plastic surgeon may continue to treat the scar post-operatively, ensuring that the scar does not reform.
When a large area of skin is damaged due to burns or other injuries, the edges may pull in, causing a contracture. Contractures can restrict normal movement by affecting the adjacent muscles and tendons. There are a few ways to treat a contracture. Your plastic surgeon may remove the scar and replace it with a skin graft or flap.
As with any type of scar, facial scars can be very noticeable and sometimes unsightly. There are several treatment options for facial scars. One method is to remove the scare and close it with tiny sutures, or stitches, thus leaving a thinner, less noticeable scar. Dermabrasion is a technique in which the top layers of the skin are scraped, leaving a smoother surface. While dermabrasion will make the scar less noticeable, it will not completely erase the scar.
There are many treatment options for scar revision. For example, the Z-Plasty technique repositions a scar so that it more closely conforms to the natural lines and creases of the skin, making it less noticeable. It can also relieve the tension caused by contracture.
A Z-Plasty is an outpatient procedure that is performed under general anesthesia. During a Z-Plasty, the old scar is removed and new incisions are made on each side. These incisions create small triangular flaps of skin, which are rearranged to cover the wound at a different angle, resulting in a Z pattern.
Another effective method are skin grafts and flap surgeries. Skin graft surgeries and flap surgeries are major inpatient procedures that are performed under general anesthesia. Healing may take several weeks, or even months. With a graft, a section of skin from one part of the body (the donor site) is removed and used to cover the injured area. Most grafts are successful, but sometimes they do not take.
Full Thickness Flap surgery is complex and involves taking not only skin, but underlying fat and blood vessels (and sometimes muscle) to use at the injured site. In general, flap surgery results in a better appearance than skin grafts.
Laser treatment has also proven to be successful in treating scars. The pulsed-dye laser has been showing some signs of success in lessening the appearance of surgical scarring. Treatment usually begins as soon as the stitches are removed and is repeated monthly.
Silicone gel and silicone gel sheeting are treatments that have proven effective for improving the appearance of both fresh and long-standing scars. Silicone gel is a thick liquid applied to the affected area. Silicone gel sheeting is a treated, fabric-like sheet that covers the scar.
Studies have shown that the gel and gel sheeting, applied for 12 to 24 hours per day for at least two months, resulted in significant improvement in appearance, as well as lessening the recurrence of hypertrophic scars.
For more information on scar treatment and revision, please contact our specialized staff at The Centre, P.C. to schedule your consultation.