Scars are a common problem that occur from a variety of events including injury, various skin conditions and surgical procedures. Removal of these scars is a frequent patient request from plastic surgeons. While scar treatments have been a part of plastic surgery for a very long time, one thing about them has always been true… scars can be reduced in appearance but they can never be completely removed. There is no such thing as scar removal. Every strategy for scar treatments is about reducing their appearance and how to make them less visible. Plastic surgeons wish they had a magical technique that could simply wipe away scars but that does not exist. The emergence of laser technologies makes it seem like this would be the definitive solution. While in some cases lasers can be helpful for scar treatment, they do not eliminate them and are frequently overpromoted for what they can achieve. Compared to surgical scar revision, lasers (and its distant cousin dermabrasion) actually plays only a secondary role in effective scar reduction. The actual cutting out of scars, if possible based on scar type, and the rearrangement of surrounding healthy tissues still remains the cornerstone of effective scar reduction therapies. Surgical scar revisions may include simple linear excisions or more complex forms such as z-plasties and a wide variety of geometric tissue rearrangements. Once these are done, the use of lasers may put the finishing touches for maximal scar appearance improvement.
Dr. Barry Eppley