When our skin is damaged in any way, the body attempts to repair the injury by accelerating its response mechanism, even reaching the deeper layers of the skin, such as the reticular dermis, if required.
During the healing process, the body produces a significant amount of collagen fibers. Gradually, this can lead to the formation of a characteristic mark on the skin, called a scar.
Surface wounds generally do not leave marks, but when the damage reaches deeper layers, collagen deposition may occur irregularly, causing discontinuity. In such cases, an unsightly scar can form, disrupting the smooth surface of the skin and causing significant discomfort for the patient. The patient is often distressed by its appearance and seeks ways to improve it. In severe trauma cases, scars can be so extensive and located in areas that cause mild to serious functional limitations for the patient.
That is where we intervene to help, offering comprehensive support and solutions for scar treatment and recovery.
Types of Scars – Surgical Treatment
There are many types of scars, depending on the cause:
- Post-surgical scars
- Trauma scars
- Acne or chickenpox scars
- Burn scars
Additional scar types include:
- Atrophic
- Hypertrophic
- Contracture scars
Moreover, keloids form a distinct category. These arise due to the overproduction of scar tissue that extends beyond the boundaries of the original injury. They most commonly occur due to acne on the chest or back, trauma, surgeries, or even after a tattoo.
Predisposition to keloid formation plays a significant role and is treated accordingly, for example with cortisone injections, cryotherapy with liquid nitrogen, and more.
It is worth noting that a scar can occur anywhere on the body, at any age, and with any size, depth, or shape. In modern plastic surgery, this is a challenge, as it gives us the opportunity to treat and correct any skin or soft tissue injury, with local or general anesthesia, based on the extent of the problem. The goal is to restore the skin and patient’s functional ability to the best possible degree.
Post-Traumatic Scar Treatment
The plastic surgeon focuses not only on the initial treatment but also on later correction of post-traumatic scars. This can be done through surgery, laser treatments, injections, or other medical treatments. In many cases, a combination of treatments is required for optimal results. Extensive scarring often occurs following trauma when healing has been delayed due to significant factors, such as infections or other intrinsic disorders. Burns can also clearly lead to serious scarring. The surgeon chooses the best technique based on the area and quality of the scar, always considering the patient’s needs and wishes. In each case, both surgical and non-surgical treatments can be offered, depending on the patient and the nature of the scar.
Non-Surgical Scar Treatments
Non-surgical treatments include various laser treatments, pressure therapy with special silicone sheets or splints, and injections such as triamcinolone combined with topical treatments. The approach depends on the nature of the scar and the time that has passed since its formation.
Surgical Scar Treatments
In surgical treatments, excision of the scar (scar excision) and re-suturing using plastic surgical techniques (scar revision) are performed. The goal of surgery is to improve the scar’s appearance, making it blend better with the skin’s natural tone and texture.
Z-Plasty and W-Plasty Techniques
Closure of the area is performed in layers so that the new scar is as flat as possible. Techniques like Z-Plasty or W-Plasty can be used, especially for challenging areas such as the armpits, neck, or around the eyes. These techniques reduce tension and distortion, minimizing further contracture of the skin. Z-Plasty is used to break up the scar with a ‘Z’-shaped incision, allowing it to better align with natural skin folds and making it less noticeable. W-Plasty is used to treat depressed or raised scars. In general, we utilize a range of techniques, often in combination, to achieve the best possible results for scar recovery.
For example, keloids have a recurrence rate of 45% or higher after excision. Studies have shown that combining excision with laser therapy, steroid injections, or other treatments can reduce the likelihood of recurrence. In certain cases, skin flaps or grafts may be required to cover the area after scar excision. It is important to understand that surgical scar correction cannot completely eliminate a scar, but it can make it much less noticeable, reduce its size and thickness, or adjust its direction, releasing tension and restoring functionality to the area it affects.
Recovery After Scar Surgery
As with any surgical procedure, recovery time depends on the extent of the surgery. The improvement in the scar’s appearance may take months to fully develop. Doctor–patient collaboration is vital, and in many cases, cooperation between multiple medical specialties is required, along with complex surgeries, to restore both form and function. Do not hesitate to visit us and discuss your concerns in person so we can help you find the best possible solution. We are here to help you achieve the best possible result — and that is our guarantee!
