Scar revision surgery is a cosmetic treatment that improves the size, shape and overall appearance of an existing scar. Scars can reside anywhere on the body and they may be recessed or raised, and for some, uncomfortable and unsightly. The goal of this surgery is to minimize the appearance of the scar and create a more natural look. Our Metairie plastic surgeons use various incision techniques to recreate a new scar that is less visible, and improve its appearance. It’s important that patients have realistic expectations. While this procedure can certainly reduce the size and shape of a scar, it will not make it completely disappear.
"Dr. Tandon's skill rebuilt my body after my cancer surgery, but his caring and compassionate (and humorous) attitude kept my outlook on life on track. I have never been a negative person, but cancer can make you question so much. Dr. Tandon never let me doubt that i could make it through. I would recommend him to everyone who is facing my situation, or who wants a physician who really cares about the total you. Thank you, Dr. Tandon, for everything!"- A.T. / Google / Nov 01, 2018
"When you are diagnosed with breast cancer, you have a lot of decisions to make. Lumpectomy? Mastectomy? Reconstruction? Immediate or delayed? Implants? Silicone or Saline? Using my own tissue? It can be very overwhelming! Dr. Tandon is patient, compassionate, knowledgeable and most importantly, extremely skilled in performing a variety of reconstruction procedures.Being a nurse with past experience in caring for patients with breast cancer was somewhat advantageous in sorting out my treatment and reconstruction options. I am also uniquely aware that surgical skill varies among surgeons. After diligent research, and my consultation with Dr. Tandon, I felt completely at ease with my decisions and confident that I had chosen the right team to provide me with the best breast reconstruction possible. The type of reconstruction we ultimately chose required an incredible amount of specialized surgical skill. I underwent bilateral skin and nipple sparing mastectomies with DIEP flap reconstruction and I could not be more pleased with my cosmetic results. Dr. Tandon is that rare combination of highly skilled surgeon combined with a kind compassionate bedside manner. I am forever grateful!"- M.E. / Google / Apr 30, 2019
"Dr. Guste is truly an AMAZING doctor. He listen and helped me make the right decision for my breast reconstruction surgery. He is a very skilled surgeon I would recommend him hands down. His attention to my needs as a patient was overall the best! He explained the procedure an helped me make the right choice. He was willing to take as much time as I needed."- A. / Healthgrades / Apr 19, 2019
"I can't recommend Dr. Jansen enough!!! The experience start to finish was fabulous. Dr. Jansen was very clear with expectations vs reality. He was very forthcoming in the procedure he would be conducting and the fact he would only conduct what he was comfortable with. It was nice to have a Dr who is so honest with his patients."- A. / Healthgrades / Apr 18, 2019
"i cannot say enough I had hesitated on several occasions to have the surgery due to my age. When I met with Dr. Guste my fears were diminished. His professionalism and personable manner won me over. The surgery was very successful with zero pain. I cannot believe the transformation. I would recommend Dr. Guste to anyone."- P.D. / Healthgrades / Apr 15, 2019
Types of Scars
There are various methods available to treat unsightly scars, but it helps to first understand the different kinds of scars.
- Superficial scars are the most subtle type of scars. They do not cause any issue other than an unsightly appearance.
- Keloid scars are larger, painful scars, which are often discolored and tend to extend beyond the edges of a wound.
- A hypertropic scar does not extend beyond the wound, but it continues to become larger, thicker, and more painful over time.
- A contracture scar develops over a larger section of skin creating a tight feel and impairing one’s ability to move. A severe burn is an example of this.
Scar revision treatment will be chosen based on the scar’s location, type, size and overall extent. There are various techniques to consider.
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.
This is also a technique used for raised scars. It can be accomplished a couple of 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 resuturing the skin in a different direction, the new scar can be minimized.
Skin Grafting/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, the surgeon will stretch and join the edges together and place sutures carefully into the tissue wall.
Scars that are depressed or concave may benefit from a filler material known as injectable derma filler. There are a wide variety of fillers on the cosmetic surgery market that may be considered. Collagen is a common filler used for scar revision. During the procedure, the injectable material will be injected into the skin through a syringe. The surgeon may manipulate the outside of the skin to help shape the surface accordingly.
Some scars can be treated with a series of skin rejuvenation treatments, which can soften the surface of the skin, smooth out uneven scarring, reduce uneven pigmentation and lighten the skin where needed. Some scars may even become non-existent because of the skin removal mechanism. Skin surface treatments include laser skin resurfacing, chemical peels, dermabrasion and skin bleaching.
All scar revision procedures are performed in an accredited surgical facility. Some procedures will require general anesthesia, but most will only need local anesthesia. Following this procedure, patients will need to adhere to a daily scar treatment regime so the wound site and new scar can heal. It is important to protect this area of skin from sun exposure to avoid any further skin discoloration. While this treatment does not fully eliminate a scar, the visible imperfections are certainly minimized. Most patients feel more confident exposing the section of skin where the unsightly scar once resided.