Scar Revision

With surgical scar revision, a scar is removed and the surrounding healthy skin is repaired in layers so as to prevent a depression at the site of the join. Wide scars can often be excised and closed resulting in a narrower, less visible scar. The same principles apply when removing a mole, cyst or a fatty tumor (lipoma). Scars should always be in natural skin creases, if possible. 

A straight scar may be converted into a zigzag or ‘Z’ configuration whose limbs fall into the natural skin creases which make it heal better and appear less visible (rather than a straight incision line). Surgical scar removal works best on scars that are mature, prominent, or have healed in a particular direction which cross the natural skin wrinkle lines rather than lying parallel to the skin tension lines known as Langer’s lines. Optimal results occur when a scar is removed and wound edges are joined without tension in layers using different types of suture material for each individual layer. The timing of removal of stitches and the method of stitching can also optimize the scar. ‘Cross-hatching’ or ‘rail-road tracks’ are prevented by using a single stitch under the skin or by removing stitches in the first two to five days after surgery.