We know through experience that the decision to have a scar correction is generally preceded by a long decision making process. With this information we would like to help you with this process, by advising you about the procedure itself and the possibilities and risks involved in this operation. This advice, does not however, replace the need for an extensive personal consultation with your surgeon who will thoroughly address your specific questions.
When is a scar correction useful?
What is the aim of a scar correction?
What do I have to consider before a scar correction (pre-operative phase)?
What do I have to consider after a scar correction (post-operative phase)?
What are the possible risks with a scar correction?
Which result can I expect after a scar correction and what are the chances of success?
Unsightly scarring. Scars can develop differently and vary in shape, colour and markedness. Scars are the result of an injury or surgical intervention, which result from the body's own healing process. Scars can present a functional limitation and are also mostly a cosmetic problem. A scar can be functionally disruptive and cause a restriction of movement due to shrinkage and tension. Furthermore, it can be easily damaged, sometimes open up or cause aggravation through itching. A scar can also be cosmetically disturbing by thickening, pulling-in, widening or be more conspicuous by its bold colour. Scars are also often emotionally stressful, as they remind the person concerned of an unpleasant event, such as an accident or illness.
The aim of scar correction is to correct scars and to eliminate function impairment and/or cosmetic problems.
Procedure. If conservative measures such as pressure treatment, scar ointments, cortisone injections, etc. do not reach their target, a surgical scar correction can better address the functional or cosmetic problems. The surgical technique depends on the type, size and location of the scar.
In some cases, a simple excision of the scar and a closing with fine stitches using a plastic suture technique can be used.
With strong scar shrinkage or with scars over joints it is often necessary to use special techniques such as a Z-plasty or a W-plasty, or other flap techniques to change the direction of the scar, so that less tension occurs on the edges of the wound, or so that the scar runs in a better direction.
With extensive scarring, a correction is only possible over several sessions, as there needs to be time in between operations for the skin to stretch, in order to be able to close the final wound.
Another technique in the correction of scars is where an expander is inserted under the neighbouring skin in the first operative session. The surrounding skin is stretched gradually by an injectable valve and in a second session, the scar is removed and the stretched skin used to cover the defect.
Other specialised techniques are skin transfers from other areas of the body, or skin removal by CO² laser.
Type of anaesthesia. The type of anaesthesia depends on the size of the scar. Usually the procedure is carried out under local anaesthetic but can also be carried out under general anaesthetic or with an epidural.
On the day of the operation please do not use any oily shower or bathing products but normal soap or shower gel and your skin should not be moisturised. Information on general measures and the necessary preliminary examinations will be put together for you personally in a pamphlet which you will receive at your consultation.
If a wound drain was used it is usually removed on the 2nd postoperative day and the stitches, depending on the technique, removed 1 to 2 weeks after surgery. Showering or bathing is not allowed until after the stitches have been removed and with scars over joints, movement is only allowed on a reduced scale. Temporary bruising, swelling or a feeling of tension regularly occurs after surgery but these changes should not worry you and should disappear within a few days.
Consequent aftercare of scars through scar ointments, scar patches, pressure treatment and sometimes surface X-ray radiotherapy is usually an essential part of therapy. The treatment can extend over many months, sometimes stretching over years.
Sports should be avoided for around 2 weeks and heat sources, such as those from saunas should be avoided for the first month after surgery. Sun protection is also necessary until the scar has faded.
No procedure is without risk. The general risks of surgery include the possibility of bleeding, thrombosis and infection. A specific risk associated with scar correction is the congenital risk of renewed scarring or keloids, which can highly depend on individual circumstances.
Faint and inconspicuous. Through the surgical procedures in general, functional and cosmetic results are improved. Although the scar maybe made longer than with other techniques, it will look more inconspicuous after healing.