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Facial scars are often a source of self-consciousness for patients. In considering surgery for scar improvement, it is important to realize that scars can never be completely removed, only made less visible.
Introduction to scar revision
The goal of surgical scar treatments is to improve the appearance of a scar; this can be done by relocating the scar or lessening its appearance. Several considerations have to made in order to effectively revise a scar - such considerations are patients' skin color and type, age, health history and the type of scarring present.
Not all scars are created equal and therefore different scars respond to different treatments. For example, Keloid or hypertropic scars are usually raised and wide, and often treated first with injections of steroids. They should be addressed in a timely fashion when they start to form.
Multiple factors contribute to scar formation, and are important considerations in the revision surgery. Maximum improvement may require more than one procedure, and takes patience on the part of the surgeon as well as the patient. Scars remodel for up to a year after the initial injury, and it is important to wait for an appropriate time before undertaking revision surgery. Different techniques may be employed, among them excision of the scar, revision with small skin flaps, dermabrasion, laser resurfacing, and filler injections for indented scars.
What is involved in this procedure?
Commonly, scar revision entails the surgical removal of the scar tissue in its entirety. Skin flaps, created by the use of healthy skin around the scar site, can then be moved to form a new incision line which will heal more appealingly. Skin grafts, wherein a section of skin from a different site is attached to the scar site, may also be used for certain revisions.
Raised scars can be effectively treated with laser resurfacing or dermabrasion. In these procedures, the upper layers of skin on the scar site are removed either with laser light or with a course-surfaced surgical implement. This makes the scar smoother to the touch and less visible.
Scars which are dark or hyperpigmented may be effectively treated using chemical peels, the strength of which is determined by the color or amount of pigmentation of the scar.
Will my medical insurance cover scar revision procedures?
Though it is generally thought of as a cosmetic procedure, and therefore not covered by insurance, scar revision may sometimes be approved as medically necessary. We are happy to submit an insurance pre-authorization request on your behalf after you have consulted with Dr. Desyatnikova.
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