|Revision of facial scars
Scars especially of the face are often a course of
severe psychological distress for the patient.
Patients must understand that the great majority of scars can not be made totally invisible but rather the aim is to make them as inconspicuous as possible. This in many cases amounts almost to invisibility.
The basic aim of scar revision is to achieve a flat, fine scar and of the same colour as the surrounding skin.
Apart from the purely cosmetic considerations, a scar may need revision if it produces a functional problem by pulling or distorting a neighbouring structure. For example ,a scar due to an old burn may prevent an eyelid from closing properly or may reduce the range of motion of a joint.
Most scars need a couple of years to settle. It is preferable to delay any revision until the scar has progressed well into the process of maturation In other words, the original redness and thickness of the scar must reverse themselves before a revision is undertaken.
To achieve the best possible results the surgeon uses refined techniques in handling the tissues. Often the original scar is removed and the direction of the new scar is altered so that it is made to be parallel to the normal crease lines of the face.
In some cases, if there is a shortage of tissue in the area, it is necessary to make use of a skin graft which is taken from another area of the body.
Sometimes revision must be undertaken in staged operations over a period of time.
It is important to bear in mind that some areas of the body will always produce relatively conspicuous scars despite all efforts to minimize them. Such areas are the upper sternum, back, lower nose and the limbs.
Very conveniently, most revisions are carried out under local anaesthesia on a day-case basis.