Minimise the Appearance of Scars

Scar Treatment Options:

Scars are a natural result of the body’s healing process after trauma, surgery, or injury. Although scar tissue is permanent and cannot be fully removed, various techniques can help improve their appearance. The goal of scar treatment is to make scars less noticeable by reducing their prominence or changing their position. It’s important to understand that while scarring can be minimized, complete removal of scars is not possible. Depending on the type of scar, options for improvement may include treatments such as steroid injections, silicone sheeting therapy, dermabrasion, and laser treatments. In cases where these non-surgical methods are insufficient, surgical scar revision may be considered to make scars less visible.

Scar Revision and Dermabrasion:

Scar revision and dermabrasion can be performed in an office setting or an outpatient surgical facility. Healing generally takes several days, with minimal activity restrictions. In some cases, scar revision and dermabrasion may be combined in stages for optimal results. Dermabrasion is particularly effective for improving acne scarring. While complete removal of acne scars is not achievable, dermabrasion can smooth noticeable imperfections when combined with other treatments. It is important that the acne be inactive before undergoing dermabrasion.

Types of Scars:

1. Hypertrophic Scar: This type of scar is characterized by excessive scar tissue in an incision or wound, appearing red, firm, and raised above the surrounding skin.

2. Keloid Scar: Keloid scars are similar to hypertrophic scars but tend to grow beyond their original boundaries. Keloids are more common in individuals with darker skin tones and may develop in areas such as the breastbone, earlobes, and shoulders.

Scar Treatment Options:

Non-Surgical Treatments:

• Fillers (Collagen or Other Fillers): Used to treat depressed scars. These fillers blend into the skin but are not permanent and typically require periodic touch-ups.

• Steroid Injections: Effective for hypertrophic and keloid scars, steroid injections flatten and soften scars but do not reduce their size.

• Pressure Therapy: A device that applies pressure over the scar, often worn for up to six months, helps to improve scar appearance.

• Silicone Gel: Silicone gel sheeting or topical silicone gel can soften and fade scars when applied regularly.

Surgical Scar Revision: Scar revision aims to reduce the visibility of unsightly scars. The success of the procedure depends on factors such as scar size, shape, location, patient age, skin type, and overall health. Dr Imani uses advanced techniques for scar revision, including Z-plasty, W-plasty, and geometric broken line closures.

Scar Revision Techniques:

• Elliptical Excision: Removal of the scar tissue with careful suturing of the wound edges.

• Z-Plasty: The scar is repositioned by making triangular flaps of skin that are rearranged to cover the wound, orienting the scar in a more favorable direction within the skin’s relaxed tension lines.

• W-Plasty and Geometric Broken Line Closures: Irregular scars are broken into geometric patterns that blend with surrounding skin.

• Tissue Expanders: Placed under the skin to expand available tissue for reconstruction, particularly for large or wide scars.

• Dermabrasion or CO2 Laser: Dermabrasion smooths scars using a rotary abrasive instrument, while CO2 lasers may be used for less severe scars.

Postoperative Course: It is important to note that keloid and hypertrophic scars may have a tendency to recur, potentially even larger than before. To minimize the likelihood of recurrence, combined treatments such as steroid injections, topical steroids, or radiation therapy may be required. Although no scar can be fully removed, the degree of improvement depends on factors such as scar size, location, skin quality, and postoperative care.

Surgical Scar Revision Risks

This includes techniques like scar excision, Z-plasty, W-plasty, or skin grafting.

1. Scarring (Again)

• Every surgical revision replaces an old scar with a new one.

• While usually improved, the result still depends on how your body heals.

• In some cases, the scar may become wider, thicker, or more visible than before.

2. Infection

• As with any surgical procedure, there’s a risk of infection at the wound site.

• Signs include redness, warmth, pus, or increased pain.

• Usually treated with antibiotics.

3. Bleeding or Haematoma

• Excessive bleeding or a blood collection under the skin (haematoma) may occur post-op.

• May require drainage.

4. Delayed Wound Healing

• More likely in areas with high tension or movement (e.g. joints), or in patients with diabetes or poor circulation.

• Smoking increases this risk significantly.

5. Keloid or Hypertrophic Scar Formation

• Some patients—especially those with a history of keloids—may develop excessive scarring again despite revision.

• Tension on the wound or certain body locations (e.g., chest, shoulders) also increase risk.

6. Asymmetry or Irregular Appearance

• Especially in areas with natural curves (e.g., face).

• Revision may improve texture but not fully match surrounding skin tone or pattern.

7. Nerve Damage

• If the scar is near sensory or motor nerves, there is a low risk of numbness, tingling, or weakness.

8. Recurrence of Scar

• In some cases, the revised scar may return to its original appearance over time.

Non-Surgical Scar Revision Risks

This includes options like laser therapy, micro needling, chemical peels, dermabrasion, steroid injections, or topical treatments.

1. Skin Irritation or Sensitivity

• Common side effects include redness, swelling, and peeling.

• May cause discomfort during and after treatment.

2. Pigmentation Changes

• Hyper pigmentation (darkening) or hypo pigmentation (lightening) of the skin.

• More common in patients with darker skin tones or after aggressive treatment.

3. Incomplete Improvement

• Non-surgical methods may soften or fade the scar but often do not eliminate it.

• Multiple sessions are often required.

4. Allergic Reactions

• Possible with topical treatments, chemical peels, or anaesthetics.

• May cause rash, itching, or blistering.

5. Skin Texture Irregularities

• Some treatments (like aggressive laser or dermabrasion) can lead to over-thinning or unevenness in the skin surface.

6. Worsening of Scar

• If improperly performed or if the skin reacts poorly, the scar’s appearance may become more prominent.

How to Minimise Risk

• Choose a qualified, experienced specialist

• Share your full medical history, including past scarring issues (e.g., keloids).

• Follow all aftercare instructions strictly.

• Avoid sun exposure and smoking after treatment to reduce the risk of pigmentation issues.

Important Information and Disclaimers:

• Any surgical or non-surgical procedure carries risks.

•  Individual outcomes, results, experience and recovery times vary based on individual’s genetics, environmental factors, diet, exercise, sun protection, smoking and general health. Individual’s outcomes are only relevant for that individual and they do not necessarily reflect or guarantee the same outcome for another individual given the same treatment.

•  The information provided is general and educational in nature.

•  It does not constitute medical advice nor replace consultation with a qualified health professional.

•  We encourage all patients to seek a second opinion and consult their general practitioner for a referral before engaging in a surgical and non-surgical consultation with us.

Still have questions?

Contact us to arrange your consultation with Dr Imani.