Though a scar cannot be removed completely it is often possible to make it appear less obvious. This can be done through the injection or application of steroid medications. Scar modification can also be achieved by a procedure known as a scar revision.
Surgical scar revision can change the size of a scar, raise depressed scars or lower elevated scars. Scar revision improves the appearance of a scar while leaving another - though less obvious - scar in its place. While a scar's color cannot be altered, color will usually fade in time.
Because every scar is different and requires a different approach, a consultation with Dr. Waslen will determine the best approach to treat your scar.
Most methods of scar revision can be done in-office using local anesthesia.
Preparing for Surgery
2 Weeks before surgery
- Avoid all aspirin containing products, all anti-inflammitory medications (ie: Ibuprophen such as Advil or Motrin), all products containing 400 IU's of vitamin E and all herbal products. These products can increase bleeding both during and after surgery and may lead to increased post-operative bruising, swelling and recovery time.
- Stop or at least cut down on smoking. Smoking constricts small blood vessels causing delayed healing, increased scarring and increased recovery time.
- Begin taking a multivitamin tablet daily, which can speed healing and shorten recovery time. It is recommended to continue your multivitamin for one month following surgery.
- Arrange for transportation to and from surgery. You must have someone responsible pick you up and remain with you for a minimum of 24 hours. You cannot take a taxi home on your own.
- It is recommended to restrict activity for approximately 2 weeks following surgery. It is advisable to make arrangements for assistance.
- Avoid dental appointments 2 weeks prior to your surgery as well as 2 weeks post operatively.
- Arnica capsules or pellets can be taken orally starting 2 days before surgery and can continue for 5 days post op. This homeopathic medication can assist in decreasing bruising and swelling due to surgery.
24 hours before surgery
- Avoid alcohol or smoking.
- Nothing to eat or drink after midnight the night before your surgery (no water, no gum). If surgery is booked after 12 noon, clear fluids may be allowed up to 6 hours before surgery (ie: black coffee/tea, clear juice, water). Our nurse will advise you on this when you are given your time for surgery.
Day of surgery
- Wear loose, comfortable button-up/zipper clothing (ie: jog suit, slip on shoes).
- Leave valuables at home (remove contact lenses, jewellery or piercing of any kind).
- Take any regular prescribed medications (ie: blood pressure medications) with a small amount of water.
Surgical Scar Revision:
During surgical scar revision, a scar is removed and the surrounding healthy skin is joined in a less conspicuous manner. Wide scars can often be excised and closed resulting in a narrower, less obvious scar; similarly, long scars can be shortened.
Irregular or zig-zag incision lines (rather than a straight incision line) are used to form a new scar that is harder to recognize. This method can also be used to move scars into less obvious places such as the hairline or a natural fold in the skin.
Surgical scar removal works best on scars that are long, prominent, or have healed in a particular shape. Best results are achieved when a scar is removed and wound edges are joined without tension.
Punch grafting is often the best treatment for deep acne scars.
This method involves using a small instrument to punch a hole in the skin, remove the scar and replace it with a small plug of new skin (usually taken from the back of the earlobe). The new skin is taped into place for about seven days to permit healing. Though punch grafting produces new scars, the new scar will be smoother and less apparent than was the depressed scar.
Dermabrasion can be used to treat acne scars, chickenpox scars, tattoos, wrinkle lines and surgical scars.
Using an electrical device that removes the top layers of skin, dermabrasion planes down an irregular skin surface. Patients can usually return to work within two weeks. Several sessions may be needed if scars are deep, such as acne scars. Click here to learn more about dermabrasion.
Laser light is used to burn away fine scars, wrinkles and sun damaged skin. Patients can return to work within two weeks, though residual redness can last up to six months. Click here to learn more about laser resurfacing.
Injectable substances such asRestylane and Perlane can also be used to fill depressed scars. While improvement is immediate, it is not permanent and continuous treatment is required.
- Some pain and nausea can be expected. This can be relieved with anti-pain and anti-nausea medications. Take them as directed. If you are coming from out of town, please have these medications with you.
- Any bandages worn post-operatively should be comfortable and not too tight. Adjust as necessary.
- Maintain a regular fluid intake during the day, decreasing fluids in the evening to help with swelling.
- Rest is important to minimize pain, nausea and swelling.
- Try to maintain an upright sitting position at all times (ie: 25-45 degree angle) for the first 2-7 days post-op. This will assist in the reduction of post-operative swelling and speed healing time.
- Begin a light nutritional regime and increase food intake as tolerated.
- Take anti-pain medications with food to avoid an upset stomach. Start taking your antibiotic (if applicable) once you have gone home from surgery, ensure to eat yogurt or alternatively take acidophilus.
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Post-operative Day 1
- You may remove the bandage and shower if you wish. Remove all gauze, but leave any white skin tapes intact for approximately 2 weeks post-op if applicable.
- Be aware of any unusual swelling or a sudden increase in pain. If either of these are noted, phone the office as soon as possible.
- Continue to maintain a regular fluid intake during the day.
- Continue to maintain an upright position. Continue to elevate buttock and use ice packs.
- Be aware of decreased skin sensation. Do not apply excessive heat or cold to the operative areas.
- Do not smoke.
- Rest as much as possible.
- A nurse will call you by noon to assess how you are doing. At this time, you will be given further post-operative instructions as well as an appointment for your first post-operative visit.
Post-operative Days 2-7
- Gradually increase your activity level after 7 days post-operatively. As individuals, everyone's post-operative healing phases will differ. Generally speaking, gentle exercise may resume at 10 days with moderate exercise resuming after 3 weeks. It is advisable to abstain from a full exercise regime until 6 weeks post-operatively.
- Scar tissue (firmness or hardening of operative tissues) may increase up to 6 weeks with the resultant softening of the tissues.
- Approximately 75% of swelling will diminish within 3 - 4 weeks. Any remaining swelling can take from 6 months to 1 year to absorb.
- Best results are usually not seen until 3 months following surgery.
- The final stages of healing are usually not complete until 1 year post-operatively.
Every surgical procedure involves a certain amount of risk. It is important that you understand the risks involved with this procedure. An individual's choice to undergo a surgical procedure is based on the comparison of risk to potential benefit. Although the majority of patients do not experience these complications, you should understand the potential complications.