Scars from accidents or previous surgery can be troublesome. Many variables can affect the severity of scarring, including the size and depth of the wound, the blood supply to the area, the thickness and color of your skin, and the direction of the scar. How much the appearance of a scar bothers you is, of course, a personal matter.

Scar revision is performed after the body has had time to heal itself (usually one year after the initial trauma). Frequently, a scar revision can be performed in Dr. Savalia's Orange County-area surgicenter under local anesthetic, allowing you to go home soon after the procedure.

While no scar can be removed completely, Dr. Savalia can often improve the appearance of a scar, making it less obvious through the injection or application of certain steroid medications or through a surgical procedure known as scar revision.

What types of scars can be treated?

The type of treatment employed by Dr. Savalia will depend on the type of scar. Here is a list of the most common:

Keloid Scars. Keloids are thick, puckered, itchy clusters of scar tissue that grow beyond the edges of the wound or incision. They are often red or darker in color than the surrounding skin. Keloids occur when the body continues to produce the tough, fibrous protein known as collagen after a wound has healed. Keloids are often treated by injecting a steroid medication directly into the scar tissue to reduce redness, itching, and burning. In some cases, this will also shrink the scar.

If steroid treatment is not effective, the scar tissue can be cut out and the wound closed with one or more layers of stitches. This is generally an outpatient procedure, performed under local anesthesia. You should be back at work in a day or two, and the stitches will be removed in a few days. Unfortunately, keloids have a stubborn tendency to recur, sometimes even larger than before. To discourage this, Dr. Savalia may combine the scar removal with steroid injections, direct application of steroids during surgery, or radiation therapy. Or you may be asked to wear a pressure garment over the area for as long as a year. Even so, the keloid may return, requiring repeated procedures every few years.

Hypertrophic Scars. Hypertrophic scars appear similar to keloids, but remain within the boundaries of the original incision or wound. They often improve on their own-though it may take a year or more-or with the help of steroid applications or injections. If steroid applications are ineffective, hypertrophic scars can often be improved surgically. Dr. Savalia will remove excess scar tissue, and may reposition the incision so that it heals in a less visible pattern. This surgery may be done under local or general anesthesia, depending on the scar's location. You may receive steroid injections during surgery and at intervals for up to two years afterward to prevent the thick scar from reforming.

Contractures. Burns or other injuries resulting in the loss of a large area of skin 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 procedure known as Z-plasty may be used. And new techniques, such as tissue expansion, may also be considered. If the contracture has existed for some time, you may need physical therapy after surgery to restore full function.

Facial Scars. Because of its location, a facial scar is frequently considered a cosmetic problem. There are several ways to make a facial scar less noticeable. Often it is simply cut out and closed with tiny stitches, leaving a thinner, less noticeable scar. If the scar lies across the natural skin creases Dr. Savalia may be able to reposition it to run parallel to these lines, where it will be less conspicuous.

Recovery time will depend on the type of procedure you and Dr. Savalia decide upon. As you heal, keep in mind that no scar can be removed completely; the degree of improvement depends on the size and direction of your scar, the nature and quality of your skin, and how well you care for the wound after the operation.

For more information on scar revision, please call or email Dr. Savalia at our Orange County-area plastic surgery office.

Contact Dr. Savalia, Orange County Scar Revision Surgeon