FIRST QUARTER 2004, VOLUME 18, NO 1

Types of scars and how to minimize their visibility

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The advantages of rejuvenation at an early age

FAQs about facial plastic surgery … are you a good candidate?

Ask the Surgeon / Health Tip / What’s New

Types of scars and how to minimize their visibility

Scars result any time the deeper layers of skin are cut or torn. The appearance of the scar is affected by many variables, such as the size and depth of a wound, the blood supply to the area, the thickness and color of your skin, and the direction of the scar. Whatever type of scar you have, chances are there is a procedure that can help make it smaller and less conspicuous. Each type of scar responds to a different facial plastic surgery technique.

Keloid. Keloids are thick, protrusive mounds of scar tissue and are often red or darker in color than the surrounding skin. Keloid scars result from an overproduction of collagen that grow beyond the margins of the original wound.

Injecting steroid medication directly into the scar tissue will reduce redness, itching, and burning. The steroid also stops collagen production, which may allow the scar to flatten and fade over time. If more revision is necessary, the scar tissue can also be excised and closed with one or more layers of stitches.

Hypertrophic Scars. Hypertrophic scars are thick, red, and raised, however, unlike keloids the scar remains within the boundaries of the original incision or wound.

You may start out with topical applications or steroid injections. If this does not seem effective, the scar can be improved surgically by repositioning the incision so it heals in a less visible pattern.

Contractures. Burns or other major injuries may form a scar that pulls the edges of the skin together, a process called contraction. The resulting contracture may affect the adjacent muscles and tendons, restricting normal movement.

Correcting a contracture usually involves cutting out the scar and replacing it with a skin graft or a flap. In some cases, a Z-plasty or W-plasty may be used. These two techniques depict the different ways to release a contracted scar – cuts that resemble a z shape or a w shape, depending on the severity of the scar.

Scars that are raised or bumpy may respond to a resurfacing technique. In laser resurfacing, the laser emits powerful bursts of high-intensity light that vaporize the scar tissue with little or no damage to surrounding areas of the skin. Another option is dermabrasion (a facial sanding technique). On the other hand, if the scar is depressed, your physician may inject dermal fillers, such as collagen, to raise the scar.

Make an appointment to discuss your options. In some cases, more than one treatment, or a combination of techniques, may be needed to attain the best results.

Although scars cannot be eliminated entirely, modern techniques can minimize their visibility making it possible for disfiguring scarring to achieve a normal appearance.