Different types of scar revision
Scar revision treatment will be chosen based on the scar’s location, type, size and overall extent. There are various techniques to consider.
Injectable treatments
Scars that are depressed or concave may benefit from a filler material known as injectable dermal filler. There are a wide variety of fillers on the cosmetic surgery market that may be considered. Hyaluronic acid fillers are commonly used for scar revision.
During the procedure, the injectable material will be injected into the skin through a syringe. Your surgeon may manipulate the outside of the skin to help shape the surface accordingly.
Surface treatments
The most common way we treat scars is with some form of microneedling treatment: either Skin Pen or Morpheus 8 (microneedling with radiofrequency). Four to six weekly treatments will often be needed to see an improvement. This is most commonly used when scars show thickening or widening. Sometimes a laser treatment may be recommended as well to diminish the red color.
Some scars that are depressed or concave may benefit from having dermal filler injected.
Skin grafting or tissue expansion
Large scars may require a skin graft (skin taken from another area on the body) to close the wound once the scar has been removed. Carefully placed sutures will be used around the graft to close and blend the skin together for healing. If a skin graft will not be used, tissue expansion may be used instead. During this process, a tissue expander will be placed under the skin where the scar resides and filled with a sterile solution. Once the expansion process is complete, your surgeon will stretch and join the edges together and place sutures carefully into the tissue wall.
Shave excision
For scars that are raised, a shave excision may be performed to remove the top of the scar and even out the surface with the rest of the skin.
This creates a smoother, flatter appearance. During the procedure, a surgical shaver is used to slowly shave off the raised portion of the scar. Sutures are not needed in most shave excision cases.
Scar removal/modification
This is also a technique used for raised scars. It can be accomplished in a few different ways. First is the elliptical removal pattern. This involves removing the scar as well as an edging (ellipse) of skin encompassing the scar so a clean enclosure can be made. The sutures may be placed on the inside or outside of the skin. Sometimes a scar exists because the incision was closed poorly. By reopening the scar and re-suturing the skin in a different direction, the new scar can be minimized.
