Scars are the result of permanent damage to the skin following an injury or surgery. Discoloration, skin irregularities and other deformations can affect your appearance in a way that’s not exactly flattering. Fortunately, there are ways to effectively lessen the severance of scars, making them less obvious. This includes scars that don’t cause impair function or cause physical discomfort, such as acne wounds and scars resulting from minor injuries.1
Scars are commonly categorized to the depths of the elevated tissue, pigment shape, and orientation. Although scars often improve with time, the human body may yield abnormal scars. These subtypes are called “hypertrophic scars” or “keloids.” Hypertrophic scars may be raised and red, and distort adjacent body parts. Keloidal scars grow beyond the zone of injury.
Pain and itching is commonly associated with scarring. There is some evidence that these symptoms may persist. The skin is a complex organ, derived from multiple germinal layers. Skin heals by the formation of a fibrous scar. Once an injury sections the deeper layers of skin, there will always be a scar. In some locations it may be conspicuous and in other locations it may be disfiguring.
Scars are a source of distress and anguish. Studies show that employment prospects may be lowered, as some potential employers may be disturbed by the appearance of scars. Dr. Fritz Gibson, a British Plastic Surgeon, wrote, “by your scars, you’ll be judged.”
If your scar is not too deep – that is to say only affecting the upper layers of the skin – then this may be a suitable procedure. It works by causing the epidermis to peel off, so in effect exfoliating the skin. Then new skin will grow back, ideally leaving the scar less noticeable than it previously was.
Similar to chemical peels, this procedure is most appropriate for scars which are not too deep. The process, similar to exfoliation, uses a dermabrasion machine to remove the top layers of the skin (where the scarring is), subsequently leaving the undamaged lower layers of the skin, resulting in a ‘polished’ or untainted appearance.
Filler Injections / Soft Tissue Fillers
This procedure is considered most appropriate for indented scars. In other words, scars which do not stick out, but instead are indented into the skin. Collagen or other suitable fillers are used to literally ‘fill the indentation’, subsequently raising it to the level of the rest of the skin, thus making it less noticeable.
Surgical Scar Revision
This is the process of surgically removing the scar and then rejoining the layers of skin and is known as ‘excision’. It cannot totally remove the scar, but can decrease the length or width of a scar. Closure of the resulting surface would is known as a “simple” closure. Layered closure is used where the excision extends to tissue below the skin surface or in areas with a high degree of movement. This first step, or layer, requires a sub-dermal closure (below the skin surface) with absorbable or non-removable sutures. Layers of closure continue to build, concluding with closure of the remaining surface wound.
Lasers, various energies and types can be used to lessen scar tissue; the type of laser depends on the age and quality of the scar as well as the skin pigmentation. Regardless, best case scenario, scar’s can be improved but rarely fully removed.
Burn scars are particularly problematic due to the loss of delicate skin structures through the noxious action of the heat, which leads to an increased amount of tension.
If a patient is seen shortly following trauma, a red hyper vascular scar is at a higher risk for hypertrophic formation. Progressive measures, such as silicone gel sheets would be helpful, along with the possibility of laser intervention. Although multiple methods of treatment exist, one could recommend silicone sheets, intralesional corticosteroids, and/or surgery.
Pressure therapy has been used, although there are mixed reports as to its effectiveness. Radiotherapy remains controversial because of reports of carcinogenesis following the procedure. Laser therapy has shown mixed results.
Promising therapies, however, include additional injections, which would be utilized to alter the immune system.
A proper evaluation and treatment can help lessen the severance of scars. Plastic surgery for scars is often the only way to remove/revise the scar. Dr. Zaydon has over 20 years experience as a Board Certified Plastic Surgeon and specializes in a variety of procedures such as Abdominoplasty, Breast Reduction, Rhinoplasty, Plastic surgery for scars and more. Dr. Zaydon works in conjunction with patients who have experienced trauma with resultant scars and is using laser therapy and associated products to help reduce these types of scars.
Scar revision surgery may be performed in your plastic surgeon’s office using local anesthesia. If your scarring is more significant and and sedation or general anesthesia is also necessary for you to be comfortable during the procedure, it may be performed in an accredited office-based surgical facility, licensed ambulatory surgical center, or a hospital. If you do require sedation or general anesthesia, you will need another adult to drive you home and stay with you for the first night following the procedure.
As per normal, a history needs to be taken as to the mechanism of the trauma. An avulsion, where there is loss of tissue, would be a more problematic scar than a “simple” cut. Furthermore, the region of the body where the wound lies is quite important. Certain areas, such as the shoulder or sternum, frequently widen and become raised above the surrounding skin. This is possibly due to high skin tension in all directions in these anatomic sites. If a wound follows a relaxed skin line, a more optimal cosmetic or functional result will become evident. Multiple smaller scars heal better than one long straight scar. Smaller scars are not subject to a “bowstring” effect of a longer scar.
When there is tissue loss, skin tension is increased at the time of closure of the wound, and the resulting scar will probably widen. The wound edges are often necrotic, and this will increase the amount of scar formation with time. In addition, detrimental foreign bodies may be evident.
If you are looking for a plastic surgeon for scars in Miami, then you may want to consider Dr. Thomas Zaydon. Dr. Zaydon has many years of experience removing and reducing the appearance and symptoms of scars and scar tissue. Read more about Dr. Zaydon in his role as a plastic surgeon expert witness, workers’ compensation plastic surgeon, or Contact Us.