Scars do not just affect people physically – they can also have negative effects on self-esteem. Scar revision procedures are designed to reduce or eliminate scars and restore your self-confidence. For the best treatment possible, those in the Canton, Cleveland and Akron areas should contact Dr. Steven Carp at his Green and Beachwood, OH clinics, Carp Cosmetic Surgery Center.
If You’re Considering Scar Revision
Whether scars are the result of an accident or surgery, they are unpredictable. How the scars develop depends on the original injury and how efficiently your body can heal. Additionally, several factors can affect how severe the scars are, including the depth and size of the wound, the color and thickness of your skin, the direction of the wound, and blood supply to the site. Whether the scars bother you a little or a lot, however, is more of a personal issue.
No scars can be completely removed, but a plastic surgeon can usually improve how they look, making it less obvious with the application or injection of steroid medications or with surgical scar revision. The following is an explanation of the most common scar types, the procedures that can treat them and what results can be expected. This will give you a fundamental understanding of scar revision, but you may have more questions related to your individual situation. Do not hesitate to ask Dr. Steven Carp at the Carp Cosmetic Surgery Center about any parts of a procedure that you do not understand.
Making the Decision
A majority of scars that look unattractive and big at first could become less noticeable over time. Some are treatable with steroids that relieve symptoms such as itching and tenderness. Due to this, many plastic surgeons suggest waiting for one year or more following an injury or surgery before undergoing scar revision.
If a scar is bothering you, the first step you need to take is scheduling a consultation with Dr. Carp. During the initial visit, he will perform an examination and talk with you about the potential treatment methods for your scar. Dr. Carp will also discuss with you the benefits and risks involved and the possible results that you can expect. When you talk about your expectations for scar revision, be realistic and frank with Dr. Carp. Also, do not wait to ask questions or discuss your concerns.
Cosmetic procedures are not normally covered under insurance policies. If scar revision is performed to improve your ability to function or to reduce scarring from an injury, however, your insurance company may partially cover the procedure. Check the terms of your policy or call your insurer to confirm.
A keloid scar is an itchy, thick, and puckered mass of scar tissue that grows beyond the edges of an incision or wound. It is usually red or dark in color compared to the surrounding skin. A keloid develops when the body keeps producing collagen, a tough and fibrous protein, even after the incision or wound heals.
Keloids can develop anywhere on the body, but are most common on the shoulders, earlobes, or breastbone. People with dark skin are more likely than fair-skinned people to develop keloids, and the tendency for keloids to develop lessens with age.
A steroid medication is often injected into the scar tissue to reduce itching, burning and redness. The injection shrinks the scar in some cases. If this treatment is not sufficient, however, Dr. Carp can cut out the scar tissue and close the wound with one or more layers of stitches. This procedure is typically performed under local anesthesia on an outpatient basis. It should only take one or two days for you to return to your daily activities such as work or school, and the stitches are removed after a few days. Occasionally, Dr. Carp uses a skin graft, but this depends on the risk of the graft site developing a keloid.
Keloids are stubborn and have a tendency to recur no matter the type of the treatment used. Sometimes they are larger when they redevelop. Dr. Carp might combine scar revision with steroid injections or radiation therapy. He could also ask you to wear a pressure garment over the site. Even with these measures, the keloid might return, so you may require additional procedures every few years.
Frequently confused with keloids, hypertrophic scars are also red, thick and raised off the skin. However, the scars remain within the boundaries of the wound or incision. Hypertrophic scars usually improve without treatment, but it could take one year or longer depending on the severity of the incision or injury. Steroid injections or applications may be used to speed up the improvement.
When a conservative approach is not effective, surgery is an option for treating hypertrophic scars. During the procedure, Dr. Carp will remove extra scar tissue and might reposition the incision so that it is less visible when it heals. Local or general anesthesia is available for the surgery, and the type used depends on the location of the scar.
Burns and other injuries that cause the loss of big sections of skin might form scars that scrunch the edges of the skin together. This process is called contraction, and the resulting contractures might affect the adjacent tendons and muscles, restricting normal movement.
Fixing a contracture typically involves removing the scar and filling the space with a flap or skin graft. A procedure called Z-plasty is sometimes used, and new techniques such as tissue expansion have become more and more prevalent over the years. Long-time contractures might require physical therapy following surgery to restore full function.
Facial scars are often considered cosmetic issues because of their location, even when they are not hypertrophic. There are numerous ways to reduce the appearance of facial scars, but they are often removed surgically and closed with tiny stitches. If a scar develops across a natural crease in your skin, Dr. Carp might reposition it to run parallel with the creases so that it is less conspicuous.
Sometimes dermabrasion, a technique that scrapes off the top layers of skin with a high-speed, hand-held rotary wheel, can soften facial scars. This technique leaves the skin smoother but does not completely eliminate the scars.
As a surgical treatment, Z-plasty is used to reposition scars so that they conform more closely to the natural creases and lines in your skin, making them less noticeable. However, not all scars are easy to improve with Z-plasty, so the procedure requires an experienced plastic surgeon like Dr. Carp to make judgments.
In a Z-plasty, Dr. Carp removes the old scar and makes new incisions on each side to create small triangular flaps of skin. He then rearranges the flaps to cover the wound from different angles so that the scar looks like the letter Z. He will use fine stitches to close the wound, and those are removed a few days later. Z-plasty is usually performed as an outpatient procedure under local anesthesia.
Z-plasty cannot make your scar disappear, but it can make it less obvious. Part of the scar will stay outside of the lines of relaxation.
Skin Grafting and Flap Surgery
Graft and flap surgeries are more serious than other scar surgeries and are more likely to be inpatient procedures under general anesthesia. It might take several weeks or months for the surgical site to heal, and Dr. Carp may tell you to wear a bandage or support garment for as long as one year.
Skin grafts involve transferring healthy skin from another part of the body, which is called the donor site, to the site of the scar. When new scar tissue and blood vessels form around the area, the body has accepted the graft. Although a majority of skin grafts are successful, the body can sometimes reject them. Also, the donor site is likely to have scarring, as is the original scar site.
Flap surgery is a complex technique in which the skin is moved from a healthy part of the body to the scarred site. The transfer often includes the blood vessels and underlying fat and sometimes includes the muscle as well. The blood supply is still attached on one end to the donor site in some cases. Other times, it is reconnected to the blood vessels at the new site via microvascular surgery.
These types of surgeries can significantly improve the function of scarred areas. However, the results may be less satisfactory if you are only concerned with how it looks. This is because the transferred skin might not match the texture or color of the surrounding skin. Generally, flap surgery provides a better cosmetic outcome than a skin graft.
After Scar Revision
It is vital that you follow Dr. Carp’s instructions following any type of scar revision to ensure that the wound heals correctly. Even though you might be able to return to normal activity rather fast, he will advise that you gradually resume certain activities.
As you heal, remember that no scar can be entirely removed. The level of improvement that you see will depend on the direction and size of your scar, how well you care for the surgical site afterward, and the quality and nature of your skin. Do not panic if your scar appears worse initially because you might not see the final results of the surgery for some time.
How Much Does Scar Revision Cost?
Scar revision is considered to be elective, so most insurance providers won’t cover the costs. To help make scar revision affordable and accessible for everyone, Carp Cosmetic Surgery Center offers financing options. We also accept cash, personal checks, and major credit cards.
If your efforts to eliminate scars has proven ineffective, it may be time to seek professional help. That help is readily available from Dr. Steven Carp, who offers scar revision services to his patients in and around Canton, Cleveland or Akron at his Green and Beachwood, OH clinics. Contact us today!