As a wound heals, tissue begins to grow over the wound, protecting it and replacing the damaged skin. As this fibrous tissue settles in, you develop a scar. Essentially, scars are nature’s way of reminding you of past injuries.
Some people don’t mind these badges of history, but others are eager to erase the evidence. The goal of a scar revision procedure is to improve or minimize the appearance of the scar. This can help you feel less self-conscious about it.
In other circumstances, a scar revision surgery can restore some function to an area where scar tissue has grown up and inhibited your usual range of motion.
It’s best to discuss your options with a doctor before deciding. You have many options to choose from when it comes to changing your scar’s appearance.
Your doctor might suggest starting out with one of several available minimally invasive procedures to see if that improves the appearance of your scar. Options include:
Your surgeon will use one of several possible techniques to revise the scar. They may use a skin graft or skin flap to close the wound. After making the appropriate incisions, your surgeon will close the wound with sutures.
In some complex cases, a surgeon may choose to suture together the tissue in layers. If they suture the tissue in layers, they will start with the tissue below the skin surface and work their way up. Multilayer repair can make it stronger, according to a 2014 review.
You can start out treating some scars with topical treatments or injections. But if you don’t get the results you’re seeking, surgery may be the next step.
If you have one of these types of scars, speak with a doctor about what kind of surgery could be effective.
If you’ve ever had surgery, you might have some scars remaining from the surgical incisions. Or you might have some acne scars that are fading too slowly for you.
Hypertrophic scars tend to be wider or thicker raised scars at the site of a wound. They’re often red or pink, but they can vary in color and sometimes appear darker or lighter.
A keloid scar is fibrous scar tissue. It forms a smooth, hard growth after a wound has healed.
Keloid scars tend to be larger and more raised than hypertrophic scars. They often grow beyond the borders of the original injury site. Keloid scars have a higher recurrence rate than hypertrophic scars, too.
Doctors often first treat these types of scars with corticosteroid injections, then possibly cutting out the scar. The process of cutting out the scar is known as excision.
If the keloid recurs after excision, the last line of treatment is to cut it out again. This is followed by immediate radiation therapy to the scar.
When a burn or other type of serious wound heals, fibrous tissue sometimes replaces the elastic tissue that was there before the injury. This inelastic tissue is known as a contracture.
A contracture feels stiff. It can restrict the usual movement of the tendons, muscles, and joints in the affected area.
Some dermatologists will suggest a cosmetic treatment like laser treatment, microneedling, or chemical peels for acne scars. If that doesn’t quite do the job, you could follow up with dermal fillers. However, minor surgery is also a treatment you might want to consider.
A depressed acne scar is one that’s sunken into the skin. If you have a depressed acne scar, your doctor can surgically “lift” the scar up to make it flush with the rest of your skin. This can make the scar less noticeable.
If you have raised acne scars, you might start with a nonsurgical treatment like corticosteroid injections. If those don’t do the job, a doctor might recommend surgery.
Your doctor may recommend additional corticosteroid treatments, or other treatments such as radiation therapy, after surgically removing the raised scar. Cryosurgery can be a good option for people with lighter colored skin who have raised scars.
You can have an injury on just about any part of your body, so you can develop a scar on just about any part, too. The type of plastic surgery that’s most appropriate for your scar can vary.
Your face is the most visible part of your body, when you get down to it. Your doctor will speak with you about the procedures that are available for scars on your face. Much will depend on the type of scar that you have on your face.
Your doctor may recommend starting out with a process like dermabrasion or laser resurfacing to smooth down a raised or rough scar. If you have a keloid or hypertrophic scar, they might suggest injections of medication to reduce the size. Then, they’ll move on to excision of the scar, according to the American Academy of Facial Plastic and Reconstructive Surgery.
Your neck is also quite visible, so your doctor may speak with you about scar revision surgery that will minimize the appearance of the scar. A surgeon may be able to work with the natural tension lines in your neck. Again, the procedure will depend on the type of scar, including the size.
You may be most concerned about function in other parts of your body. For example, if you have a contracture from a burn on your hand or leg, you may want to pursue a scar revision to ease some tension and restore some lost movement. According to a 2014 review, a procedure like a variation on a Z-plasty can lengthen the scar and improve the tension that tends to accompany this type of scar.
Here’s what you can expect from a typical scar revision surgery. Your results may vary.
One of the biggest risks of scar revision surgery is that you may not get the exact results you want. Every scar is different, and a procedure that worked on one scar might not be as effective on another.
You may want to consider other potential risks of undergoing surgery. They include:
Consider your budget and the cost of scar revision surgery carefully before you make a final decision. If you have insurance, there’s a good chance that your policy may not pay for a scar revision surgery if it’s for aesthetic purposes. However, if your scar is the result of trauma like a burn or accident, it’s possible that your insurance may cover some of the cost.
In the meantime, speak with your doctor about the estimated price of a scar revision procedure. The price can vary, depending on:
Some doctors suggest that a smaller scar revision might cost around $500. More extensive revisions may cost as much as $4,000 or more.
Before any scar revision procedure, your doctor will want to meet with you to assess your scar. They’ll look for a variety of characteristics, including its:
They’ll also note the area where the scar is located and any tissue stiffness. Then, your doctor will discuss your options with you, including the benefits and risks.
Once you decide upon a specific procedure, your doctor will discuss the actual surgery including the techniques. They will also give you some pre-op instructions to help you prepare. Typically, these will outline behaviors you may want to avoid before your surgery, such as smoking or drinking alcohol.
Before your surgeon begins the scar revision procedure, you will need to receive anesthesia. Depending on the procedure, you may only need local anesthesia and can be awake during the procedure. But sedated anesthesia or general anesthesia may be appropriate in other situations. Then the procedure can begin.
There are several types of scar revision surgery, and one of them may be appropriate for you.
The surgeon will remove the scar and carefully sew the remaining edges together.
Not every scar revision surgery will require a skin graft, but sometimes, it’s necessary. If so, your surgeon will remove the scarred area. Then, they’ll place a piece of skin taken from another part of the body to replace the removed skin. Finally, they’ll sew it into place. This procedure is often used for burn scars.
This surgery is similar to a skin graft surgery. Your surgeon will move a flap of skin from another area of the body to replace the skin removed when the scar is excised.
During this procedure, the surgeon repositions the scar so it falls more along the natural lines of your skin. According to a 2019 review, these lines are known as relaxed skin tension lines. The surgeon does this by creating tiny triangles along the margin of the scar.
The W-plasty is a fairly versatile procedure with minimal risk. It can be particularly useful when revising hypertrophic scars. The downsides: it may not be appropriate on scars in the eyelid area and can result in a longer scar, according to a 2019 review.
With a Z-plasty, your surgeon moves or redirects the lines of the scar to make it less noticeable. The surgeon creates pointed flaps of skin, which can lessen the tension or pressure from skin tightness of some scars. Research from 2010 suggests that it can help break up a scar so it’s better camouflaged, or help a tight scar relax. According to a 2014 review, this procedure also has numerous variations.
The recovery process can vary, too, depending on how extensive the surgery was. Typically, your doctor will go over how to take care of your surgical site. For example, they may tell you to take it easy for a few days or weeks to avoid putting any strain or stress on the wound as it heals.
You may also notice some swelling or bruising around the site during the first 1 or 2 weeks after the surgery. You can use cold compresses to keep the swelling down. Let your doctor know if the swelling or discoloration doesn’t eventually go away.
Be sure to visit your doctor for any scheduled follow-up visits, even if your surgical site seems to be healing up just fine.
Another key piece of advice: Protect your scar or scar revision from the sun as much as possible. A broad-spectrum sunscreen or protective clothing should do the trick.
It’s also important to be patient. Penn Cosmetic Surgery cautions that the healing time may be longer for a scar removal on your leg than for a scar removal on your face. And it may take months for you to fully realize the improvement to your scar’s appearance.
You may be a good candidate for scar revision surgery if you:
Also, make sure you know why you’re considering scar revision surgery. According to the American Society of Plastic Surgeons, the key is that you’re doing it for yourself, not to please someone else.
Your best choice for a doctor to perform your scar revision procedure is a board certified plastic surgeon or dermatologist. These are physicians who have completed medical school and a residency program, then voluntarily pursued extra medical education in their specialty area and passed rigorous exams to demonstrate their mastery. They must also keep up their education to maintain their certification.
Wondering where to find a highly qualified doctor or surgeon? You can search for a plastic surgeon or dermatologist through search tools provided by the:
When you find a doctor, you may want to ask them some questions to make sure they’re a good fit for you. Those questions might include:
You might also want to bring along your own medical history, including your family medical history and information about any previous surgeries you’ve undergone.
Scars can vary in size, shape, and thickness. Some are barely noticeable, while others are impossible to miss. Your available treatment options will depend on the location and type of your scar, as well as your budget. In some cases, a surgical procedure may be the right solution for you, but consult your doctor about all your options first.
Last medically reviewed on April 11, 2022
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