Scar revision means to make scar cosmetically and aesthetically appealing to reduce and minimize it by surgical or non surgical techniques so that it merges with your skin perfectly. Naturally scars take couple of months to a year to naturally fade and merge one should wait till scar matures after the wound healing. And ideally scar revision to be performed 2-3 months after it matures completely.
Scars can be treated surgically or by semi invasive procedures like undermining, dermabarasions, fractional resurfacing lasers, fillers depending upon the type weather the scar is normal, hypertrophied elevated, depressed or atrophic or ice pick scars, its size, and location of the scar and by which methodology one gets the best cosmetic result, some times more than one scar revision treatments can be used to get beat desirable result.
1.Surgical removal of scar
Surgical removal of scar can be done by simple and closure in case of small scar where closure is possible or by Skin flaps & Z-pasty if simple closure is not possible , for perfect fine tension free closure, in some cases if much more tissue is damaged or lost we do skin grafting ,can be full thickness graft or split thickness depending upon scar ,if much more skin tissue is lost we might require reconstruction with help of tissue expansion.
In Undermining or subcision we lift or elevate the depressed scars with hth help of cutting needles in this procedure we break those collagen fibers which are holding the scar down with dermis ,which releases the dermal anchoring and produce new collagen and matrix below the scar which is responsible for scar lifting. it is safe less invasive and gives long lasing results
In Dermabrasion we remove or abrade upper lasers of skin with the help of dermabrader which can be wire brush or diamond brush burr depth of dermabrasion weather superficial or deep depends upon the severity and depth of scarring, after procedure the new skin which is formed is much smoother skin with minimal scaring.
4. Fractional laser resurfacing
Fractional laser resurfacing can be ablative and non-ablative. Common Ablative fractional resurfacing laser is, fractional carbon dioxide (CO2) which completely resurface the skin and gives excellent results but takes longer time to recover. Most popular Non-ablative fractional skin resurfacing lasers is fractional Er- Glass laser which gives mild result it penetrate deep into the dermis of the skin and stimulates new collagen to smoothen the scarring it is having a much less down time as compared to fractional co2 but no of sessions required are more.
Post operative care in surgical removal of scar is important, simple dressing with anti biotic creams, stitch removal within a week pressure dressing if scar is hypertrophied .
In semi invasive procedures is to avoid sun and apply anti septic creams till healing & sun screens 3-4 hrly to minimize post inflammatory hyper pigmentation if you take proper post procedure care you will get best cosmetically pleasing out come even though we cannot erase it completely.