Scar Revision

Scar revision improves a scar that has healed badly. Your surgeon removes the old scar and closes the wound again with fine technique, placing the new line along a natural skin crease so it is less noticeable, and breaking up a straight tethering scar with small triangular flaps where it pulls.

It suits a scar that is wide, raised, depressed, discoloured or set at an awkward angle to the creases, after a burn, an injury, acne or previous surgery. A scar that limits how a joint moves needs a contracture release instead, which is a larger operation.

A scar cannot be erased. The realistic aim is to trade a poor scar for a thinner, flatter, better-aligned one, and to give it the pressure garments, silicone and massage that help it mature well.

Most revisions are done under local anaesthetic as a Day Care procedure. A large scar, or a child, needs a general anaesthetic.

Your surgeon marks the plan on the skin, excises the scar, and releases the tissue beneath it so the edges come together without tension. Where the scar crosses a crease or pulls, it is redirected with a Z-plasty, and a small graft or local flap is used if the gap will not close. Fine stitches close the surface. Most take 30 to 90 minutes.

You go home the same day with a dressing and, over a joint, sometimes a splint.

Stitches come out at five to seven days on the face and ten to fourteen elsewhere. Keep the wound dry for two days, then wash gently. Most people are back at desk work within a week and avoid stretching the area for three to four weeks.

The new scar goes through the same cycle as any other: red and firm for two to three months, then softening and paling over a year. Silicone gel or sheeting daily for three months, massage once the wound has healed, sun protection over the scar and pressure garments where your surgeon prescribes them all measurably improve how it settles. Judge the result at a year.