What results can I expect from scar revision surgery after worsening scars around my ear and face?

It always depends on what your scars look like.  Options for Scar Revision (scar treatment / scar improvement / scar reduction, scar removal) include:

1. excision and reexcision: straight closure, running w plasty, multiple z plasties, geometric closure.

2. skin resurfacing: including laser, dermabrasion, chemical peels

3. tissue expanders to recruit more skin

4. local flap surgery whereby skin and tissue are recruited to reline the areas of scars

5. free flap surgery where tissue from some other part of the body is transferred to the areas of the scars and connected with blood vessels.

Many scars are excised and reclosed.  There are many options with this approach.  You can cut the scars out and close them as a straight line.  Your eye however usually notices anything that is longer than 7mm.  So many times, it helps to close the new incision not in a straight line but broken up into “w’s”, “z’s”, or multiple patterns (geometric line closures).  This is done in attempts to trick the mind by not having any line longer than 7mm.

Resurfacing is always an option to improve the scar by taking the scars away on the surface and allowing new skin to grow over to improve the appearance.  This can be done with lasers, dermabrasion, chemical peels, and dermasanding.

If there is a big area to improve, sometimes having more normal looking tissue is needed. This is where the concern with bringing in tissue comes into play. Tissue expanders allow you to make more skin. You have to go through expansion of your skin with a balloon under the skin near the area you are wanting to correct.  Expansion occurs every 2-3 weeks.  Once you have enough tissue you can then take the expander out and then the new tissue is used to reline the scarred area.  Local flaps can be rotated into the area.  If this is not enough, you can then take skin and tissue from another area and hook up the vessels to reline the scarred area.

The other option includes fillers that are an adjunctive option.  Fillers essentially fill in the volume deficiency that sometimes is present in the scarred area.  Fat injections, which are a filler that uses your own fat can fill in volume and also regenerate your skin through incorporation of new stem cells in the fat.  These stem cells can have a regenerative property on scar improvement.

From a results standpoint, you shouldn’t expect it to make your scar back to complete normal.  This is impossible.  But through scar revision the scars can be really improved.  That is the key to scar revision the word “improve”.  Here is a video on Scar Revision.

Thanks for reading

Dr Young

Dr Young specializes in Facial Cosmetic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

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