When
the skin is in the process of recovering from an injury,
whether the result of an accident, surgery, a burn,
or acne, scarring will occur wherever multiple layers
of the skin have been affected. Once a scar forms, it
is permanent but may be made less visible or relocated
surgically.
With
very few exceptions most people are self – conscious
about facial scars. Some people may also experience
diminished functioning of eyes, mouth or nose due to
scarring. If you’ve wondered how facial scar revision
could improve your appearance, your self – confidence,
or your level of facial functioning, you need to know
how scar revision works and what you can expect from
this procedure.
FACIAL
SCARS
Because
of its location, a facial scar is frequently considered
a cosmetic problem, whether or not it is hypertrophic.
There are several ways to make a facial scar less noticeable.
Often it is simply cut out and closed with tiny stitches,
leaving a thinner, less noticeable scar. If the scar
lies across the natural skin creases (or “lines of relaxation”),
the surgeon may be able to reposition it to run parallel
to these lines, where it will be less conspicuous.
Some
facial scars can be softened using a technique called
dermabrasion, a controlled scrapping of the top layers
of the skin using a hand – held, high – speed rotary
wheel. Dermabrasion leaves a smoother surface to the
skin, but it won’t completely erase the scar.
Z
– Plasty is a surgical technique used to reposition
a scar so that it more closely conforms to the natural
lines and creases of the skin, where it will be less
noticeable. It can also relieve the tension caused by
contracture. Not all scars lend themselves to Z- plasty,
and it requires an experienced plastic surgeon to make
such judgments.
Skin
grafting, flaps, low- dose steroid injections can also
help in selected cases.
Scars that are well settled and not very prominent can
be concealed with cover- up make up too.
KELOID
SCAR
Keloids
are thick, puckered, itchy clusters of scar tissue that
grow beyond the edges of the wound or incision. They
are often red or darker in color than the surrounding
skin. Keloids occur when the body continues to produce
the tough, fibrous protein known as collagen after a
wound has healed.
Keloids
can appear anywhere on the body, but they’re most common
over the breast bone, on the earlobes, and on the shoulders.
They occur more often in dark – skinned than in those
who are fair. The tendency to develop Keloids lessens
with age. Keloids are often treated by injecting a steroid
medication directly into the scar tissue to reduce redness,
itching and burning. In some cases, this will also shrink
the scar.
If
steroid treatment is inadequate the scar tissue can
be cut out and the wound closed with one more layers
of stitches. This is generally an outpatient procedure,
performed under local anesthesia. You should be back
to work in a day or two, and the stitches will be removed
in a day or two, and the stitches will be removed in
a few days. A skin graft is occasionally used, although
the site from which the graft was taken may then develop
a Keloid.
No
matter what approach is taken, Keloids have a stubborn
tendency to recur, sometimes even larger than before.
To discourage this, the surgeon may combine the scar
removal with steroid injections, direct application
of steroids during surgery, or radiation therapy or
you may be asked to wear a pressure garment over the
area for as long as a year. Even so, the keloid may
return, acquiring repeated procedures every few years.
IS
FACIAL SCAR REVISION FOR `YOU?
The
most basic requirement for, all surgery is good health.
Other requirements are more subtle and should be carefully
considered in discussion with your surgeon. Expectations
of the surgery and of the surgeon must be realistic.
A person considering facial scar revision must understand
that there, is no way to remove scars completely. The
goal is to remove the appearance of the scar either
by disguising it or relocating it, or minimizing its
prominence. Skin color and type, age, and type of scarring,
are all important factors that must be part of the discussion
prior to surgery.
MAKING
THE DECISION FOR SCAR REVISION
Whether
the surgery is desired for functional or cosmetic reasons,
your choice of a facial plastic surgeon is of paramount
importance. Your surgeon will examine the scar in order
to decide upon the proper treatment and inform you of
outcomes that can be expected from facial scar revision
surgery.
Different
scars require different treatments. For example, severe
burns that destroy large sections of skin cause 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 a result of the skin’s overproduction
of collagen after a wound has healed. These scars generally
appear as growth 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 may also restrict the natural movement
of muscles and tendons.
Some
facial scars are unattractive simply because of where
they appear on the face, while others affect facial
expressions. All surgical possibilities will be discussed
in the initial consultation along with risks involved
for each type of scarring . The agreement between you
and the surgeon on how to proceed is a prerequisite
for successful surgery. After you both decide to proceed
with scar revision, he will inform about the anesthesia,
the surgical facility, any secondary surgeon, options
and costs.
Because
scars are highly individualistic and the patient’s attitude
towards scar is personal, maximum improvement in facial
scars may require more than one procedure, and more
than one technique may be employed.
AFTER
SCAR REVISION
As
you heal, keep in mind that no scar can be removed completely;
the degree of improvement depends on the size and direction
of your scar, the nature and quality of your skin, and
how well you care for the wound after the operation.
If your scar looks worse at first, don’t panic – the
final results of your surgery may not be apparent for
a year or more.
