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Insight on Scar Revision

The occurrence of scars is a frequent fact of life. As a plastic surgeon, I usually see several patients a week who come in just to have a scar evaluation and talk about what can be done to improve the appearance of their scars. Many have unrealistic expectations or inaccurate or even false information about what scar revision can accomplish.

In reality, while scars can occur anywhere and from just about anything, there are only 4 basic scar problems that make them more noticeable than we would like. Treatments for scars are based almost exclusively on this appearance classification. Scars can be too high (raised), too low (depressed), too wide (wide), or with poor color. (red or brown)

While most scars can be cut out and reclosed, otherwise known as re-excision or scar revision, certain types of scars may be successfully treated by other methods. Raised scars can be treated by steroid injections, pulsed light, or mild laser resurfacing in an attempt to flatten them, depressed scars can be treated by injectable fillers although that effect may be only temporary, and scars with red or brown discoloration can be treated by pulsed laser light in an effort to remove the unnatural color. Wide scars can be treated only by….re-excision, as there is no non-surgical method to narrow a scar.

Much ado has been made of scar treatment gels, which have become very popular in the past decade. Certainly using topical gels early after the scar is created can’t hurt (whether they really help or not has not been conclusively proven for most of them), but an established scar rarely gets any significant improvement from the external application of any cream, gel, or salve.

Seeing an experienced plastic surgeon is the best way to get good answers about whether scar revision is a good option for you.

Dr Barry Eppley

Indianapolis, Indiana

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