When your skin is cut or damaged, your body sends a flood of collagen to repair and rebuild the wounded tissue, forming a scar. The scar tissue takes on various sizes, shapes, and colors and almost always poses an aesthetic problem. But it can also create physical discomfort. Some scars are itchy or painful, and others restrict movement.
Although no scar can ever be completely removed, fortunately, there are ways to minimize their appearance and reduce discomfort. Dr. Kiran Polavarapu, our Harvard-trained, board-certified surgeon at Polavarapu Plastic Surgery in Fort Worth, Texas, specializes in scar revision surgery. Here, she discusses what you can expect during this procedure.
How scar tissue forms
When you damage your skin, your body responds by amping up its collagen production. The sturdy collagen fibers build up and replace the damaged tissue, which always looks different from your original skin.
Scars are usually flat and pale, but keloid and hypertrophic scars can appear raised, those that involve muscle and fat tissue can look pitted and sunken, and some can even form beyond the boundaries of the original wound. Some scars called stretch marks form when your skin stretches beyond its normal limits, even without breaking the skin.
Topical treatments, such as vitamin E and cocoa butter, may help heal wounds and prevent excess scar buildup, but they won’t do much to reduce scar tissue once it’s formed.
Chemical peels, dermabrasion, steroid injections, and laser resurfacing can lift away minor scars that reside in the outer layer of your skin, but older, deeper scars require surgical intervention.
What to expect with scar revision surgery
Scar revision surgery is a customizable procedure that’s as unique as your scar. Dr. Polavarapu examines your scar tissue and considers several factors before developing a surgical plan, including the:
- Depth of the original wound
- Age of the scar
- Condition and thickness of your skin
- Color of your skin
- Type of scar
- Amount of blood flow to the area
- Direction of the scar
- Location of the scar
Once Dr. Polavarapu has discussed your surgical options and explained the realistic potential outcomes, she schedules your procedure and gives you general pre-surgery instructions.
Before scar revision surgery
Some scar revisions only require a local anesthetic, but severe scars call for more extensive surgery and general anesthesia, which means you’ll need to take certain precautions to ensure a safe and effective surgery. Dr. Polavarapu may instruct you to:
- Stop smoking (if you smoke)
- Adjust your medications
- Avoid aspirin and other anti-inflammatory drugs
- Refrain from eating or drinking several hours before your procedure
These precautions reduce your risk of complications.
During scar revision surgery
For minor scars treated, Dr. Polavarapu numbs the area with a local anesthetic, cuts away the excess scar tissue, and closes the wound with tiny sutures. She prepositions the incision, so the new scar tissue forms less visibly.
Some keloid scars require skin grafts, skin taken from another area on your body. However, if you’re prone to developing keloid scars, they may reoccur after the surgery. Dr. Polavarapu decreases the likelihood by injecting a steroid into the wound and using radiation therapy.
Contracture scars may also require a skin graft. In many cases, Dr. Polavarapu uses the Z-plasty surgical technique to relieve tension and increase function. Some facial scars also benefit from Z-plasty to help the scar conform to the face's natural contours.
If you’re a good candidate, Dr. Polavarapu may employ a tissue-expansion technique to increase the area of healthy skin. She inserts an inflatable balloon under your skin near the scar and fills it with a sterile solution to stretch your healthy skin over time. Once your healthy skin has increased, she removes the balloon and the scar, using your healthy skin to cover the wound.
After scar revision surgery
You can expect some swelling and discoloration for a couple of weeks after your scar revision surgery. Dr. Polavarapu may instruct you to avoid certain activities that involve your incision for a while.
Your new scar will continue to heal over the next several months, but you can expect it to be smaller and less conspicuous than the scar you had removed.
If you have a scar that’s bothering you, contact us by phone or online to schedule a consultation with Dr. Polavarapu today.