Question: Can a facial scar be removed with surgery?
Answer: Unfortunately, scars are not removed but just improved. The goal is to take a scar that is very visible to the naked eye and make it much harder for one to see it even though there will still be a line there on close inspection. The things that make a scar visible are if it is very straight, if it is of a different color than the surrounding skin, if it is at a different depth or convexity than the surrounding skin, if it is in a direction that runs counter to the normal lines on the face or if it is pulling unnaturally on surrounding tissues causing distortion. Therefore, the goal of a scar revision is to improve all of these conditions. When a linear scar is cut out and replaced with a line however it just looks like another line. The goal is to make a line difficult to see by making it zig zag in minute little bends so that the eye has a hard time seeing it as a straight line. This is visual trickery. The gold standard of a scar revision is a geometric broken line repair that helps to truly irregularize a scar into tiny bends of triangles, trapezoids, etc. making it very hard to visualize if done well and if healing goes well. This line can be further softened with dermabrasion down the road as need be. Other methods like a z-plasty can be helpful to realign a scar that is misplaced in its direction i.e., that runs counter to the natural collagen lines of the face, or that is too shortened and contracted causing tissue distortion around it. A z-plasty is used to change the direction of a scar and to lengthen a contracted one.