Scar Revision Surgery Beverly Hills

Conveniently located to serve the areas of Beverly Hills and Los Angeles

Description

The skin is the largest organ in the body, and serves may purposes, including temperature regulation, protection against germs, sensation of the world around you and as a protective barrier, among others.  After being injured (through trauma, surgery or other causes), all skin heals as a scar. The appearance of a scar can range from completely inconspicuous, to potentially disfiguring. The amount of scarring is determined by the person’s age, heredity, skin characteristics (including pigmentation), and the wound size, depth, and location.  A scar looks different when compared to natural skin because new scar tissue consists of different amounts of collagen and other tissue material when compared to normal skin. In some cases, skin trauma cha result in hypertrophic or keloid scars that are large or even disfiguring.

In some cases, scars can naturally diminish over time – however, they never heal completely on their own.  Scars can be almost unnoticeable and of no concern, or can be an extreme source of displeasure, embarrassment of concern to an individual – it is a very personal issue.  Fortunately, with advances in the field of plastic surgery, there are many ways to treat unsightly scars.  At Gabbay Plastic Surgery, Dr. Joubin Gabbay M.D. offers the option of scar revision surgery to improve and/or diminish the appearance of your scar(s). Scar revision surgery can restore function, and correct skin changes caused by an injury, wound, or a previous surgery. Although it is impossible to completely remove any scar, utilizing the latest in surgical technology, Dr. Gabbay can dramatically enhance the appearance of your injured skin tissue.

Just as wounds vary in terms of size, scope, depth, and location, the scars that form around them vary in similar ways. Scars may be raised or recessed, different in color or texture from their surrounding healthy tissue, or particularly noticeable due to their size, shape, and/or location. During your initial consultation, Dr. Gabbay will conduct a thorough medical evaluation and gather all of the pertinent factors about your injury and overall physical health, before selecting the appropriate method and techniques to utilize during your scar revision surgery.

Scar revision is often performed as a simple office based or outpatient procedure. Recovery form the procedure is generally quick, and while your initial postoperative improvement will be dramatic, it may takes months or even over a year to see the final improvement.  At Gabbay Plastic Surgery, whether you elect to have scar revision surgery for functional or cosmetic reasons, Dr. Gabbay will evaluate your specific needs, and will ensure that your surgical goals are brought to fruition. If you would like additional information about scar revision surgery, please contact Gabbay Plastic Surgery today—we are happy to answer all of your questions and to set up an initial, complimentary consultation with Dr. Gabbay.

Details

The skin is a complex organ that serves as a protective barrier for the body. In this protective capacity, the skin is exposed to a number of harsh environmental elements, and increased potential for injury. The skin responds to injury by forming scar tissue, which is a predominantly fibrous tissue composed of collagen (produced by fibroblasts in the areas of the skin near the site of the wound), which is used to heal the areas of damage, and to stimulate the body to produce new, healthy cells.  Scars are visible on the surface of the skin because the organization of scar tissue is not the same texture or color as the original skin.

When collagen levels exceed the tissue needs, scars can form as raised, red lumps on the skin’s surface (Keloid-Hypertrophic scars). Other types of disfiguring scars include: widened scars, and depressed scars.  Keloid scars continue to expand beyond the original size and shape of the wound, while hypertrophied scars expand within the confines of the original wound.  Widened scars occur when wounds separate during the healing process, usually as a result of tension perpendicular to the edge of the wound.

Before & After Photos

Is A Scar Repair Right For Me?

There is no way to completely remove a scar from the surface of the skin; therefore, expectations of scar revision surgery must be realistic. The goal of scar revision is to improve the appearance of the scar, either by disguising it, relocating it, or minimizing its prominence.  A patient’s skin color, age, and the type of scarring are all important factors for determining the outcome of successful scar revision surgery.

Scar revision surgery is a highly individualized procedure, and may be a good option for you if:

  • The appearance of a scar bothers you anywhere on your body
  • You are physically and mentally healthy
  • You do not smoke
  • You have no underlying health conditions that could affect the outcome of scar revision surgery
  • You have a positive outlook and realistic goals for your scar revision surgery

There are different types of scar disfigurements that can be corrected during scar revision surgery, including:

  • Discoloration and Surface Irregularities
  • Hypertrophic Scars
  • Keloid Scars
  • Contractures

Evaluation

During your initial consultation at Gabbay Plastic Surgery, Dr. Gabbay will examine your wound and discuss the possible methods of treating your scar, the risks and benefits involved, and the possible outcomes.  After assessing your scar, Dr. Gabbay will create a customized treatment plan utilizing the optimal techniques to ensure the success and safety of your scar revision procedure.

Steps to The Procedure

Scar revision procedures are meant to minimize the appearance of the scar, so that it blends naturally into your surrounding skin tone and texture. The general scar revision procedure involves the following steps:

  • Step 1—Anesthesia: Medications will be administered for your comfort during the surgical procedures and may involve local anesthesia, intravenous (IV) sedation, or general anesthesia, depending upon the type and complexity of the surgery you are having.
  • Step 2—Surface/Topical/Injectable Treatments: Some scars can be treated with one or more less invasive techniques, such as:
    • Topical Treatments—Gels, tapes, or external compression can aid in wound closure and healing, and can prevent your skin from producing irregular pigmentation and discoloration.
    • Injectable Treatments—Injectables are often used to fill depressed or concave scars, and the results may last anywhere from three months to several years. Injectable treatments must be repeated periodically in order to maintain the beneficial results.
    • Surface Treatments—This approach is most often used to soften surface irregularities and reduce uneven pigmentation. Surface treatments such as dermabrasion, laser/light therapy, chemical peels, and skin bleaching agents are used to either mechanically remove the top layers of skin, or to improve the condition of the skin tissue.
  • Step 3—Surgery: For particularly deep scars, surface and injectable treatments may not be sufficient to product optimal results. For these scars, Dr. Gabbay may elect to incorporate surgical excision techniques, tissue expansion procedures, and/or skin grafting techniques into the scar revision treatment plan. The aforementioned surgical techniques may be employed on their own, or in conjunction with less invasive scar revision measures.

Recovery

Following your scar revision procedure, bandages or dressings will be applied to keep the treatment site clean, and you will be given specific instructions that will include how to care for yourself after your procedure, the medications to apply or take orally to aid in healing and reduce the risk of infection, and when to follow-up with Dr. Gabbay.  Following all of the instructions is key to the success of your surgery, and it is important that the surgical incisions are not subjected to excessive force, abrasion, or motion during the healing process.

The initial healing phase after your surgical scar revision may include localized swelling, discoloration, or discomfort, which may take 1-2 weeks to subside.  You should avoid any activity that places undue stress on the incision area, and you may use cold compresses to reduce swelling.  The length of your recovery period will depend on the type, degree, and location of the scar. The healing process will continue for several weeks, and as the new scar heals, it will slowly fade and become increasingly inconspicuous.  You should avoid exposure to the sun for several months after treatment, and will be advised to use a sunblock or wound dressing dressing (such as a Band-Aid) when out in the sun, because exposing the scar to the sun may cause it to permanently tan and become discolored.

Rare scar revision complications include: bleeding (hematoma), infection, delayed healing, anesthesia risks, change in skin sensation, damage to skin structures, skin contour irregularities, skin discoloration and swelling, skin sensitivity, pain, negative reactions to medications, blood clots, scar recurrence, separation (dehiscence) of the wound.

Frequently Asked Questions (FAQs)

What is a scar?

A scar, also known as a cicatrix, is fibrous tissue that is visible following a wound and the formation of scars is a normal part of the healing process.

What is scar tissue?

Scar tissue is primarily composed of collagen, which is produced by fibroblasts in areas of the skin near the site of the wound.

What is scar revision surgery?

Scar revision surgery is a form of plastic surgery that is designed to minimize or change the appearance of a scar so that it will be less visible, and the procedure can be for cosmetic or therapeutic reasons.  Scar revision surgery also restores function and corrects skin changes (disfigurement) caused by an injury, wound, or previous surgery.

Will scar revision surgery take my scar away completely?

While no scar can be removed completely, scar revision surgery can improve the appearance of a scar, making it less obvious by successfully changing the way the scar looks.

What are some of the options used in scar revision surgery?

Many different procedures can be used in scar revision surgery that include skin resurfacing, bleaching or changing the color of the scar, filling the scar, grafting new skin on the scar area, cutting out the scar, and/or creating an incision to reshape the scar.

Why do I have to wear a special dressing after my scar surgery?

Special dressings may be used after the surgery to reduce the risk that the scar will reform, and to keep the surgical site under pressure to encourage it to heal smoothly and evenly.

Why are scars so different?

Scar tissue forms as skin heals after an injury and the amount of scarring may be determined by the wound size, depth, and location or the person’s age, heredity, and skin characteristics including pigmentation.

Who chooses to have scar revision surgery?

How much the appearance of a scar bothers a person is a personal matter.  While some people accept and live with their scars, most people are self-conscious about their scars, considering them a detriment to their appearance, and they choose plastic surgery to improve the way they look as well as their self-esteem.

Why do some people wait so long after their injury to have scar revision surgery?

Different types of scars respond to different plastic surgery techniques, and the timing of surgery is an important choice.  Some people may be advised not to have any scar revision treatments for a designated period of time after their injury, to allow their body enough time to fully heal.

Why do scars heal differently?

Whether scars are caused by accidents or previous surgeries, they are unpredictable and the way a scar develops depends on your body’s individual healing capabilities, and how you take care of the wound during the healing process.

What are the most disfiguring scars?

When a wound heals, a scar takes its place, and sometimes the scar is inconspicuous or it can be disfiguring.  Examples of disfiguring scars include keloids, widened scars, and hypertrophied scars.

What is a keloid?

A keloid is a type of swollen scar that grows much larger than other scars, appearing similar to a fibrous tumor. Keloids are not especially dangerous, but they do cause discomfort and itching,and they may also limit movement if they become too large; especially if they are located around the joints of the body.

What is a hypertropic scar?

Hypertropic scars are thick clusters of scar tissue that develop directly at a wound site, and they are often raised, red, and/or uncomfortable and they may become wider over time. Hypertropic scars can be hyperpigmented (darker in color) or hypopigmented (lighter in color).

What is the difference between a keloid and a hypertrophied scar?

The difference between a keloid and a hypertrophied scar is that a keloid continues to enlarge beyond the original size and shape of the wound, while a hypertrophied scar enlarges within the confines of the original wound.  Both can be red and raised, however, keloids continue to grow,and hypertrophied scars tend to regress over time.

What are contractures?

Contractures are scars that restrict movement, due to skin and underlying tissue that pull together during healing. They occur when there is a large amount of tissue loss, and they can also form where a wound crosses a joint, restricting movement of the fingers, elbows, or knees.

What are some treatment options to correct a scar?

Your treatment options may vary based on the type and degree of scarring and can include:

  • Simple topical treatments
  • Minimally invasive procedures
  • Surgical revision with advanced techniques in wound closure

When should I consider scar revision surgery?

Problems that may indicate a need for scar revision include:

  • A keloid, which is an abnormal scar that is thicker and a different color and texture than the rest of your skin.  Keloids extend beyond the edge of the wound and are likely to come back and they often create a thick, puckered effect that looks like a tumor.
  • A scar that is at an angle to the normal tension lines of the skin.
  • A scar that is thickened.
  • A scar that causes distortion of other features or causes problems with normal movement or function.

Do scars ever return after surgery?

Both hypertrophic and keloid scars can recur after surgical excision, however, the recurrence of keloid scars is more common.

Why doesn’t our skin repair itself without a scar?

When a wound heals, a scar takes its place. In the human body, tissues such as fat, connective tissue, and epithelium regenerate, but the skin is a complex organ, and the injured skin cannot “grow back.”  To compensate for this, the skin heals itself by replacing the damaged tissue with scar tissue.

How do I know if scar revision surgery is right for me?

Scar revision is a highly individualized procedure and you should do it for yourself: not to fulfill someone else’s desires or to try to fit some sort of “ideal” image.

You may be a good candidate for scar revision surgery if:

  • A scar bothers you anywhere on your body
  • You are emotionally and physically healthy
  • You do not smoke
  • You have a positive outlook and realistic goals for your scar revision surgery
  • You do not have active skin diseases in the area to be treated (including acne)

What types of surgeries are used for scar revision surgery?

  • Skin Flap—When a scar is of the contracture type, surgery generally involves removing the scar tissue entirely. Skin flaps composed of adjacent healthy, unscarred skin are then lifted and moved to form a new incision line.
  • Skin Graft—Where a flap is not possible, a skin graft may be used. This involves taking a section of skin tissue from one area, and attaching it to another. Time must be allowed following surgery for new blood vessels and soft tissue to form.
  • Z-Plasty—Z-plasty is a method to move a scar from one area to another (usually into a natural fold or crease in the skin to minimize its visibility), and while Z-plasty does not remove all signs of a scar, it does make it less noticeable.
  • Laser Resurfacing—Dermabrasion and laser resurfacing are methods a surgeon uses to make “rough or elevated” scars less prominent by removing part of the upper layers of skin with an abrading tool or laser light.  Clearly, the scar will remain, but it will be smoother and less visible.