Scar Removal

HOW DOES IT WORK?

What is scar removal?

Scar removal is simply the removal of aesthetically unattractive or harmful scar tissue. Scars vary, and there are a number of procedures to remove scars. But all have the effect of altering the appearance of skin, and restoring a healthier, more natural look.

How does scar removal work?

The most common form of scar removal involves using steroid injections to make raised scars shrink in size, although dermabrasion, topical creams, peels, and skin graft or incision surgery can be recommended. If you choose a surgical route, the procedure will usually be as follows:

• Patients will attend a consultation with their cosmetic surgeon, where it will be agreed that surgery is the appropriate way to proceed. The risks will be explained, and you should leave with a clear picture of anticipated results.
• When your surgery date arrives, you will need to be admitted to hospital. A local anaesthetic will be administered around the scar region.
• Surgeons will then make precise incisions to remove the skin affected by scarring. They will then move onto closure - the key part of the scar removal process.
• Surgeons must ensure that scar revision doesn't result in similar aesthetic problems. To do so, they must apply layered sutures to rebuild the skin around the scar area. These layers are formed from healthy tissue in the scar region. They may also be created via skin grafts, or artificial tissue substitutes.
• When layering is complete, the incision will be sealed and dressed, and you will be able to leave hospital within 1-2 days.

This is one way to approach surgical scar revision. Another option involves tissue expansion. This is a longer-term procedure, requiring multiple admissions, involving the implantation of a saline-filled balloon beneath the scar. As the balloon expands, it has the effect of stretching healthy skin - preparing the way for a simple operation to remove the scar.

As usual, you will be able to discuss which procedures are most appropriate for your circumstance when you attend preliminary consultations.

Are there different types of scar removal?

The procedure detailed above is only one form of scar removal, and it may not be prescribed by your cosmetic surgeon. Instead, they will most likely recommend non-surgical interventions, leaving surgery as a secondary option. These non-surgical methods include:

• Laser removal: Surgical lasers can be used to burn off scars. This can be carried out without a hospital admission and tends to take a couple of hours. Laser methods vary. For instance, fractionated methods are more precise and result in collagen stimulation, but are less powerful. Laser resurfacing can be more effective and permanent, but slightly more painful, and recovery times are longer.
• Dermabrasion: This technique involves using abrasive tools to gently remove the outer layer of the skin, taking scar tissue with it. This may well be the best option for relatively minor scarring, where deep tissue damage is not present, and it is commonly used to deal with acne scarring, as well as sun damage.
• Steroid injections: Steroid injections are another common non-surgical scar removal intervention.Steroids work by breaking down the bonds within scar tissue and reducing its size over time. They are particularly effective in resolving hypertrophic scars.

In addition to these common methods, you may find the surgeons recommend the use of silicone sheeting (one of the least invasive options), or the use of tools designed to exert pressure on scar tissue. However, this treatment is not preferred in most cases due to the need to wear devices regularly over long periods.

What should I expect?

Every patient has a different scar removal experience, so it is difficult to say what to expect from the process. In general, you should expect to consider various options, meaning that the preparatory phase is extremely important. Talk openly about your aims and desires with your surgeon, and don't be afraid to ask about various methods. If you require surgery, expect a period of 6-8 weeks (and perhaps longer) before seeing the results. Wounds made during layering and skin grafts require time to heal, and tissues in the skin must adjust to surgery.

Similarly, if you choose non-surgical methods, it is important to give them time to work. Removing scars is not simple, as surgeons are essentially exchanging one scar for another. Skilled practitioners can ensure that the result is hard to distinguish from healthy skin. But getting there takes time.

Finally, if one method does not succeed, there may be alternatives. So don't assume that the final results are permanent. You may have other remediation options.