What is a scar revision?

Do you have an elevated, depressed, wide, or discolored scar? While scars cannot be completely removed, they can be made thinner and less noticeable. In some instances, they can be reoriented in a less conspicuous placement, such as in a wrinkle or fold of skin. Dr. Miller prefers a technique called serial excision, wherein the scar is removed in stages over multiple procedures.

Who should seek scar revision? 

Do you have scarring from a previous surgery, injury or other traumatic event? Has the scar had at least a year to fully mature? If so, a scar reduction could improve the way you look. Below are common reasons patients seek out a scar revision:

  • There is a mass of scar tissue on the body
  • Scarring is wide and noticeable
  • Keloid scars 
  • Sutures from a previous wound were left in too long and left marks upon removal
  • Tension of a previous incision resulted in scaring

How does Dr. Miller perform a scar revision?

When approaching a troublesome scar, Dr. Miller removes just a piece of the scar tissue first, then elevates the surrounding tissue before gently closing the surrounding skin. The key is to reduce tension on the healing tissue as much as possible. Pulling or tension on wounds results in poor scarring.

Once the excision of stage one heals (usually after a few months), Dr. Miller performs another excision to remove even more of scar tissue, continuing in this way until the scar is almost imperceptible. As the size of the scar lessens, healthy tissue replaces scar tissue. Rendering scars invisible is still beyond the scope of plastic surgery, however, Dr. Miller can effectively thin and reduce a scar’s presence and blend it in with the surrounding healthy tissue.

What can I expect during the procedure?

A scar revision surgery takes about an hour, though this varies on the size and length of the scar. It almost always takes place under local anesthesia while the patient is awake and completely comfortable. The local area is numbed with a solution that also reduces blood flow, which minimizes bruising and chance of infection. Dr. Miller then gently cuts out a piece of the scar tissue, raises the surrounding unscarred skin, and sutures the area, making sure there is as little tension as possible. Some procedures require a set of buried sutures, which are hidden under the skin and dissolve over time. A successful scar revision demands careful evaluation and surgical technique, preferably performed by a specialist in facial plastic surgery.

What results can I expect?

The body has a very effective way of making scars look better over time, and it typically takes up to a year for skin to fully heal. The scar will be visibly thinner and smaller, and overall less obtrusive. While the scarring won’t look elegant immediately after the procedure, its appearance will vastly improve after the sutures are removed and the skin flattens. As mentioned earlier, scars never fully disappear, but you can reduce them.

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Before & After

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The recovery process

Recovery from a scar revision requires no downtime, though there will be bruising and swelling of the area for at least 1-2 weeks. Dr. Miller will place either specialized anti-tension wound tape on the affected area, or utilize a silicone-based healing pad or gel that will keep the area flat as it heals.

Improvement will continue over the next few months, and discoloration is to be expected. This is because extra blood will flow to the area until the skin heals, at which point circulation will return to normal, and coloring should match surrounding skin; in some cases, it might be a little lighter. Dr. Miller will schedule post-operative visits to monitor healing and adjust care as needed.

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Miller has experience and meticulous technique

For the past three decades, Dr. Miller has been focused on cosmetic and reconstructive surgical solutions for the face and neck. He is double board certified in Facial Plastic & Reconstructive Surgery and Otolaryngology/Head & Neck Surgery and loves what he does. Dr. Miller stands apart from his peers because of his approachability and genuine desire to make each patient love the way they look. Patients view him as an easygoing expert they can trust. Contact Dr. Miller’s office today to schedule your free consultation!

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