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. Metairie plastic surgeons, Dr. David Jansen and Dr. Ravi Tandon, 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.
"After losing weight with lapband I was left with hanging skin. I had spent years changing my lifestyle . I had to find a plastic surgeon that was equally invested in ME! I spent years researching both my procedure and Dr. Jansen. I am so thankful I choose him! I am 2 months post op, and my body is amazing. He literally broke me out of my shell. The time, craft and consideration he has given me is wonderful. His staff has also taken their time. From my intail consult I was informed how insurance is processed. The secretary was very informative and kind explaining the restriction the office has when it comes to dealing with insurance . I can't thank Dr. Jansen or his staff for doing such a wonderful job !"- B.M. / Vitals / Apr 03, 2015
"I met Dr. Tandon when I was diagnosed with Breast Cancer last May. I was fortunate enough to have caught the cancer early and my first course of action was surgery. At our initial meeting, Dr. Tandon spent almost two hours with me discussing various options and answering all of my questions. Not only is he a phenomenal surgeon, he really cares about his patients and helping them make good decisions during a stressful and emotional time. His staff is also extremely helpful."- C.C. / Healthgrades / May 11, 2017
"Let's do the Right Thing .... A great experience at Jansen Plastic Surgery - Dr. Jansen did my liposuction almost 16 years ago. I was always happy with the procedure.Then menopause happened. There were inches that just wouldn't go away no matter how much I dieted or exercised. I saw Dr. Jansen again just a couple of weeks ago. What I respect about him most is he doesn't do procedures, just because the patient wants them. Dr. Jansen, took into account my medical..."- J. / RealSelf / May 09, 2017
"My daughter was 4 months old when Dr. David Jansen did her first laser surgery on a hemangioma tumor on the right side of her neck that was connected to her main artery. He placed her on steroids and did a second laser surgery when she was 8 month s old. My daughter is now 18 and in college at LSUA in Alexandria to become a registered nurse. Dr. Jansen saved my daughter's life and I can never thank him enough or praise him enough for the excellent job that he did!"- J.F. / Google / Mar 12, 2017
"I had a breast augmentation by Dr Jansen on a Friday. I was very worried about missing work and the recovery period. To my surprise , I cooked myself dinner that night , had brunch with friends the next morning , went to the Endymion parade the following afternoon and attended work on Monday. I did not take one pain pill and zero bruising. Truely remarkable recovery. Most importantly, my breast turned out remarkable. They are perfect and look and feel natural. I would highly recommend Dr Jansen. He is talented and friendly! Nothing but positive things to say : )"- Anonymous / Vitals / Mar 08, 2017
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.