Scar revision basics

When I look at a scar I consider a number of things when I think about a possible scar revision (Dr Young has extensive experience in scar revision in Bellevue, WA) First thing to realize is that people tend to see and notice lines that are longer than 0.7cm.  Anything longer than that, a person is more easily able to identify the line.  So if a straight scar is longer than this it may be prudent to break it apart. This can be done with z plasty where the scar is broken up by a z pattern.  Or a geometric line closure, where the scar is broken up by a combination of squares, half circles, triangles etc.  That way, the scar is not noticed as much. If it is depressed, you should exise the depressed portion and close the new incision with it being elevated.  I have a number of techniques to do this.  The closure should be done in such a way that the incision is closed as the finest line possible.    After closure, I like to do resurfacing with either dermabrasion or co2 resurfacing or a combination 6-8 weeks later.  Ice pick scars can be elevated by excising around it and elevating the tissue and then with reclosure.  Box car scars that are a square or rectangular areas that are depressed can be elevated and then closed in the elevated state.  If the area is a large depressed area, sometimes rotating flaps into the area is the best and this depends on how it looks and how large and if there is tissue in the area.  Also the tissue in the area cannot be around a vital structure like the eyebrow, mouth or eye.  But even around these structures flaps can be developed and used for reconstruction purposes. Here is a video on Scar Revision.

scar treatment geometric line closure video

Thanks for reading, Dr Young

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

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