Scars, whether they’re caused by accidents or by surgery, are unpredictable. The way a scar develops depends as much on how your body heals as it does on the original injury or the surgeon’s skills. 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, but our goal at Ponte Vedra Plastic Surgery is to ensure that we offer you the best care options available. While no scar can be removed completely, our plastic surgeons can often improve the appearance of a scar, making it less obvious through the injection or application of certain steroid medications or through surgical procedures known as scar revisions.
Types of Scars
There are various methods available to treat unsightly scars, but it helps to first understand the different kinds of scars.
- Superficial scars are the most subtle type of scars. They do not cause any issue other than an unsightly appearance.
- Keloid scars are larger, painful scars, which are often discolored and tend to extend beyond the edges of a wound.
- A hypertropic scar does not extend beyond the wound, but it continues to become larger, thicker, and more painful over time.
- A contracture scar develops over a larger section of skin creating a tight feel and impairing one’s ability to move. A severe burn is an example of this.
Scar revision treatment will be chosen based on the scar’s location, type, size and overall extent. There are various techniques to consider.
For scars that are raised, a shave excision may be performed to remove the top of the scar and even-out the surface with the rest of the skin. This creates a smoother, flatter appearance. During the procedure, a surgical shaver is used to slowly shave off the raised portion of the scar. Sutures are not needed in most shave excision cases.
This is also a technique used for raised scars. It can be accomplished a couple of different ways. First, is the elliptical removal pattern. This involves removing the scar as well as an edging (ellipse) of skin encompassing the scar so a clean enclosure can be made. The sutures may be placed on the inside or outside of the skin. Sometimes a scar exists because the incision was closed poorly. By reopening the scar and resuturing the skin in a different direction, the new scar can be minimized.
Skin Grafting/Tissue Expansion
Large scars may require a skin graft (skin taken from another area on the body) to close the wound once the scar has been removed. Carefully placed sutures will be used around the graft to close and blend the skin together for healing. If a skin graft will not be used, tissue expansion may be used instead. During this process, a tissue expander will be placed under the skin where the scar resides and filled with a sterile solution. Once the expansion process is complete, the surgeon will stretch and join the edges together and place sutures carefully into the tissue wall.
Scars that are depressed or concave may benefit from a filler material known as injectable derma filler. There are a wide variety of fillers on the cosmetic surgery market that may be considered. Collagen is a common filler used for scar revision. During the procedure, the injectable material will be injected into the skin through a syringe. The surgeon may manipulate the outside of the skin to help shape the surface accordingly.
All scar revision procedures are performed in an accredited surgical facility. Some procedures will require general anesthesia, but most will only need local anesthesia. Following this procedure, patients will need to adhere to a daily scar treatment regime so the wound site and new scar can heal. It is important to protect this area of skin from sun exposure to avoid any further skin discoloration. While this treatment does not fully eliminate a scar, the visible imperfections are certainly minimized. Most patients feel more confident exposing the section of skin where the unsightly scar once resided.
Some scars can be treated with a series of skin rejuvenation treatments, which can soften the surface of the skin, smooth out uneven scarring, reduce uneven pigmentation and lighten the skin where needed. Some scars may even become non-existent because of the skin removal mechanism. Skin surface treatments include laser skin resurfacing, chemical peels, dermabrasion and skin bleaching.
Scar Revision Reviews
"Dr. Hollie is a wonderful doctor. She has the most amazing bedside manner and you leave feeling like you have made a new friend. Not only that, but she does AMAZING work!! I have had a breast lif with implants, botox and scar revision work all by Dr. Hollie and I look and feel great! My confidence is much higher now and I love the way I fit into my clothes after having 2 children! She is fantastic and you will love the work she does on you!!"- Anonymous / Vitals / May 01, 2012
"I was bitten by a large dog. He got the entire right nostril. I went to a plastic surgeon and was told, "you will never look the same, get used to people starring....." I was told the only option I had was to use skin from my face which would cause further deformation. I was heartbroken, I thought I had no other options and my face would be scared for the rest of my life. When I came to PVPS I really had low expectations and was just defeated. Dr. Sternberg, Robin, all the Ladies working were so wonderful and sympathetic in what I felt was the worst time of my life. I had no idea what the procedure was going to end up looking like, I just knew that for the first time a surgeon gave me options, hope, and made me feel like there was a possibility of my nose looking symmetrical. I could not have asked for better results! Absolutely AMAZING. I can't believe how natural looking the nasal repair turned out! If I didn't tell you what happened, you wouldn't even know. I am SO grateful, and pleased with Dr. Sternberg, Robin, PVPS in general. I would recommend him and the office for anyone's plastic surgery needs. I can never thank them enough for helping me to feel beautiful, normal, and happy again."- K.G. / Office Visit / Jan 22, 2016
The cost for scar revision treatment varies depending on what type of procedure was performed. Unfortunately, this can range from several hundred dollars for a skin resurfacing treatment, to several thousand for a surgical procedure.