Category Archives: Scars

Understanding Scar Revision

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Purpose of Scar Revision


Psychological and physical considerations

Many patients who present themselves for reconstructive surgery suffer from PTSD (post traumatic stress disorder.) In order to provide the best solution for the patient a cosmetic doctor will address the psychological trauma with a therapeutic adjunctive consult. In such cases it is paramount that therapist have exceptional experience in PTSD for the patient negotiating serious psychological trauma. Though elected the scar revision surgery can exacerbate the patient’s fears.

Scar revision in most instances requires a waiting period. This time allows for patients not suffering from PTSD to psychologically adjust to the prospect of one or more additional surgeries to bring about reasonable consideration of their proposed surgical treatment plan.

Realistic perspective is critical in scar revision and reconstructive surgery. Healing time is quite often lengthy; the patient’s understanding of this is important to their well being. Many cases present the need for adjunctive medical treatments such as dermabrasion, steroid injections or laser resurfacing.

Preparation for Scar Revision

Timing of scar revision

The location of injury and type of scar combined with an individual’s psychological readiness are all critical to the timing of scar revision. Following the initial injury a six to twelve month wait is not unusual. Surgical intervention can only take place after a thorough consult an assessment. This assessment will most often define the following five major factors:

  1.  the characteristics and nature of the initial injury
  2. the relationships to anatomic location and relaxed skin tension lines (RSTLs)
  3. likelihood of pathologic healing (such as  hypertrophic scar , keloid )
  4. any regional functional impairment by deformity ( such as  oral or ocular impairment)
  5. surgeons should also recognize that conservative nonsurgical methods may be applicable as a primary treatment method

 
These are just some of the general factors in scar revision. This is a complex and highly individualized medical treatment. Availing oneself for scar revision takes expert medical consult. It is best to research the best cosmetic surgeons in this area and interview with several.

Scar Revisions New Horizons with Lasers

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Laser Instrumentation for DermatogistsScars are immensely varied and come in all shapes and sizes. Surgery remains the best option for more severe scars, other scars can be treated with the advance development of lasers for dermatological use. Treatment of scars with laser has steadily grown, giving both patients and physicians more flexibility to determine the best method of treatment.

Two Main Goals of Treatment
Scars appear different, depending on the injury sustained. According to some experts the color be it, white, red, or brown, can be an indicator of the type of texture the scar will show.
• Make the scar smooth without the is not depressed or elevated
• Blend the color around and within the scar so that it blends with the outlying pigment

Ablative Technology

For larger and more severe scars, such as burns and contractions associated with scars, ablative technology is a better option. Ablative technology is a process of placing tiny holes in the skin with lasers that allow tissue to bend more easily, thus potentially increasing the range of motion in severe scars. This technology continues to improve through the enabling deeper penetration of the lasers.
With lasers now offering the ability to go deeper into the skin scar treatment will continue its dramatic changes.

Some dermatologists and researchers theorize that deeper treatments will allow for more range of motion in scars that restrict movement; this may open up whole new possibilities for scar treatments. Lasers in the future will allow for even deeper penetration of the dermal layers.

Given the nature of scars, there will likely never be a definitive treatment for all scars, no matter how much the technology advances. Still the current levels of laser therapy provide wonderful new treatments to diminish scarring; with greater promise on the future.

Considering Scar Revision Surgery

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Enhancing your appearance with scar revision surgery

There is not a person on the planet who is scarless or a tleast it is highly unlikely. Scars are visible signs that remain after a wound has healed. Scars are unavoidable results of injury or surgery, and the results of this natural healing process can be very unpredictable. Some people naturally heal well; others do not… Poor healing may contribute to scars that are unsightly or disfiguring. Even a wound that heals well can result in a scar that affects your appearance. Scars may be raised or recessed, different in color or texture from surrounding healthy tissue or particularly noticeable due to their size, shape or location.

Facial Scar on Young GirlYour treatment options vary based on the type and degree of scarring and can include:
• Simple topical treatments
• Minimally invasive procedures
• Surgical revision with advanced techniques in wound closure

Scar revision surgery is meant to minimize the scar so that it is more consistent with your surrounding skin tone and texture.
Although scar revision can provide a more pleasing cosmetic result or improve a scar that has healed poorly, a scar cannot be completely erased.

Should I Elect Scar Revision?

Scar revision is a highly individualized procedure and you should do it if it adversely effects your self image and esteem.. Scar revision can be performed at any age and is a good option if:

• You are upset by a scar anywhere on your body
• You are physically healthy
• You do not smoke
• You have a positive outlook and realistic goals for your scar revision surgery
• You do not have active acne or other skin diseases in the area to be treated

Ethnicity and Scarring

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Skin Color and Scarring

Increasingly in pluralistic social cultures in the western societies people’s outward appearance may not be the best indicator of the inherited ethnicity. Ethnicity plays a significant part of how skin heals from injury or after surgery.

According to a national report in treating skin of color (SOC), expert physicians necessarily should consider not only patients’ desires and skin color. Additionally, and of prime importance is also the consideration of the patient’s ethnicity and history of scarring, post-inflammatory response, hyperpigmentation (PIH) and tanning.

Dr. Elliot Battle is CEO and President of Cultural Dermatology and Laser Center, Washington, and clinical instructor of dermatology, Howard University College of Medicine. He emphasizes that skin color and ethnicity are separate factors. He comments that out of 1,000 people with the identical skin color, “We would most likely have 1,000 different combinations of African, Caucasian, Latin, Spanish, Indian and Asian ethnicities,” he continues, adding that along with skin color, “Those combinations of ethnicities determine how one’s skin reacts to lasers and skin products.”

Understanding this it is important that your dermatologist to cultivate the habit of asking about a patient’s ancestral history — the ethnicity of their parents and grandparents. “We see many patients who might appear to be Caucasian, but one of their parents or grandparents might be a person of color,” he says. “The future of skin treatments will add ethnicity to the criteria for choosing parameters.

When concerned about scarring for any type be certain that your chosen physician has a good understanding of ethnicity and how it effects scarring.

Healing the Scars of War Victims

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No single group deals with more debilitating scarring then victims of war; both military and civilians. The decade of wars heralding in the 21st Century has left millions of people suffering from life changing injures. Along with the emotional and tragic psychological scars are the physical scars as a reminder. There are organizations globally seeking to help people who unfortunately suffering from the life lone effects of debilitating human conflict. Share this resource with any person who can benefit.

Thanks the MEDSCAR team.

AFIRM
The Armed Forces Institute of Regenerative Medicine (AFIRM) is a multi-institutional, interdisciplinary network working to develop advanced treatment options for our severely wounded servicemen and women. They develop advanced treatment for severely wounded servicemen and women. This organization is designed to speed the delivery of regenerative medicine therapies to assist the most injured service members. The five major research programs include Burn Repair, Compartment Syndrome Repair, craniofacial Reconstruction, Limb and Digit Salvage, and Scarless Wound Healing.

Air Force Wounded Warrior
The Air Force Wounded Warrior ensures great care, services, and assistance before and after wounded warriors separate or retire. They have a strong emphasis on ensuring wounded airmen individualized guidance and support to help them transition out of the Air Force and back to civilian life. The Air Force Wounded Warrior, working closely with the Secretary of Defense programs, will keep these men and women on active duty.

Iraq Star, Inc.
Iraq Star is a recently founded non-profit organization. It offers surgery for disfigured veterans. Iraq Star recruits plastic surgeons across the country to provide free cosmetic surgery for soldiers who want to fix their deformities including scars.

Scars To Freedom
Scars to Freedom Foundation, provides FREE scar revision to all Military Veterans. This is our way of thanking them for their sacrifice and service for our Country.

Understanding Scarring and Scar Revision

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The role of scar revision is to restore self-esteem and improve the quality of life. The skin is actually the largest organ of the body and vital to not only our physical health but also it’s health and beauty important to our emotional well-being. Scars have a natural process or progression towards a mature scar. This represents the completion of the healing process.

There are individuals who heal with very little scars and others who scar from the slightest of skin injury. Any injury to the the skin, that is a rupture to the integrity of its’ surface or that results in an opening or damage to the dermis, will heal with a scar.

Facial Scars effect self image.
Life changes that effect our hormones can effect the way our skin heals. Childhood to puberty, adulthood and finally to old age can represent significant changes in how our skin heals. Predicting how a person heals cannot be done with medical certainty. It is a persons observation of their own healing history and familial history that provides the best indicators.

However through observation of certain skin types that we understand their tendencies to produce abnormal scarring and formation:

  • Pigmented skin and Celtic skin have a higher risk of Hypertrophic and Keloid scarring
  • the chest and shoulders, eyelids, lips or labia heal with inconspicuous scarring

    • The goal of scar revision surgery is to make the scar to blend or making it inconspicous. Scars that result from injuries, burns or cancer excision can have a major psychological impact. This impact from the scarring can be profound adversely effecting self-esteem, self-confidence and social interaction. If you suffer from such issues a cosmetic surgeon can often help.

    Do’s and Dont’s of Reducing Scars

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    Scars are made up of the protein collagen which is found in the second layer of your skin. When the integrity of the skin is compromised through injury beyond a superficial this layer must repair itself. It is in the body’s only healing process that scarring takes place.

    The key to preventing scars is to break up the collagen that collects in the dermal tissue during the healing process. When the collagen does not bond to your skin’s top layer scar formation is reduced.
    It is possible to lighten and revision an old scar, your best approach is to limit scars before they form.

    DON’T

    DON’T Use Hydrogen Peroxide: While the solution cleans, it also destroys new skin cells that immediately begin to grow in the wound. This slows down the healing process and increased the risk of scars forming.

    DON’T Treat with Vitamin E. Recent studies show that it, like hydrogen peroxide, vitamin E impairs healing. One-third of people will also develop an allergic reaction to vitamin E.

    DON’T Expose To Sun: Ultraviolet rays slow the healing process and can discolor the scar. The sun stimulates the cells that produce pigment, and when your skin is sensitive and healing, it’s prone to discoloration. Cover the wounded skin with a minimum SPF blocker of higher than 15.

    DO

    DO Cover A Cut: Should a cut “breathe,” or does it require a Band-Aid over it? When you don’t cover a cut, it dries out and scabs over. Scabbing is not a good thing; it only presents a barrier to healing. Treating cuts with Neosporin (or another antibiotic cream) and covering with a band-aid for a week in aids the healing and prevents infections and minor skin wounds. Do this until new skin begins to grow.

    DO Place Pressure On Cut:Use special pads that serve to flatten scars. These scars don’t allow the collagen to pop up above the skin when a wound is healing. Some examples of these pads are: Curad Scar Therapy Cosmetic Pads, ReJuveness Pure Silicone Sheeting, Scar Fx and Sypres Scar Sheets.

    DO Massage The Wound: Once new skin has grown, massage the mark. Massaging helps break down the dense bonds of collagen. If they are not allowed to take hold, the appearance of the scar will be much less noticeable, or may not form at all. Massage – with lotion – in a circular motion for 15 to 30 seconds a few times a day.

    Scar Revision Primer

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    The skin is the largest organ of the body covering it in its’ entirety. Serving as the body’s protective barrier it also makes the skin the most vulnerable part of the body. There is probably no human on earth whose skin does not have a mark or scarring from some incident of disorder. The process of healing from injury or surgery leaves scarring on the skin. This can be from the tiniest of insect bites or blemish to a life saving surgery.
    Breast Scars Revision

    The amount of scarring may be determined by the size, depth, and location of the wound; the age of the person; heredity; and skin characteristics including color (pigmentation). No scar can be removed completely. The degree of improvement will depend on variables such as the direction and size of the scar, the age of the person, skin type and color, and hereditary factors that may precondition the extent of the healing process.

    Scars can be a lasting a giveaway of cosmetic surgery. Thus, one of the concerns for many patients when they consider elective surgery is the possibility of scarring. Scar revision can help to mitigate the appearance of a scar through several options. A doctor can offer a topical to help a scar to fade and, in some cases, minimally invasive procedures or even perform revision surgery to help obscure a scar.

    While there is no procedure that allows for complete removal of a scar, there are several types of procedures that improve the appearance of your scar. Scar revision surgery treatment methods include injections, skin grafting, Z-plasty, laser and lightening techniques that can drastically diminish the appearance of your scar.

    There are several things to consider before undergoing a procedure to help improve the appearance of a scar. If the scar is a problem, you don’t smoke and you are otherwise healthy, scar revision may be an option. Also, a doctor can help you determine if you have any acne or other problems that may impact an attempt to improve the scar. Patients need to have realistic expectations. While scar revision can help minimize the aesthetics of the scar, it usually cannot remove the scar completely.

    Scarring from Cosmetic Surgery

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    Facial Surgery Scars

    All surgeries leave some level of scarring and in general peopled don not like seeing scars on their bodies. Facial scars are often the most emotionally devastating. Than why do thousands of mean and women each year elect to undergo face lifts and other cosmetic procedures to keep a youthful appearance? What about the scarring. There are various ways in which surgeons hide and mitigate scarring. Mitigation of scarring in the surgery is critical for the success of the patient.

    Surgical scar from cosmetic procedure are often hidden aroun the hairline.

    The nature of facial cosmetic surgery demands thorought research by a patient. Interviewing several surgeons who are experts in the particular procedure you need is important. Also understanding how they will mitigate the appearance of the surgical scars bears a thorough understanding by the patient. Reviewing untouched before and after photos of each doctor under ones consideration should be part of the process of finding a surgeon. There also surgeons who specialize in facial scar revision which reduces the appearance of the scar.

    Basic Scar Science

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    Why do scars have different colors?


    New scars would always turn out to be red or purple in color as a result of damaged blood vessels and inflammation. These are hyperpigmented scars. Older scars are white in color. Resulting from the inflammation and damage to the blood vessels and cells loss of pigmentproducing,cells occur. The scar becomes hypopigmented (pale), because of the loss of skin pigment. The skin has a great capacity to regenerate itself. The scars are a sign of the skin attempting to heal itself. Normally when the skin is quickly repaired, the new skin may have a different appearance. This persistent in the formation of the scars that don’t fade away.

    How long does it normally take for scars to fade to their final color?

    Generally, major scars from either surgery or injury take about six to twelve months to fade to
    their final color.

    How good is scar revisioning?

    Do some people have a predisposition to develop more prominent scars?

    It believed that genetic factors play a role in the scarring process. Scarring may be more disfiguring for some people. There has been new treatment developed that can help scars fade
    away.

    What causes scars?

    Scars are a permanent mark that indicates the skin’s attempt to heal itself. When the skin is damaged the top layer occurs, cells to quickly multiply to form new cells to fill in the gap. When the wound is deeper into the underlying skin tissue, the cells that form collagen are stimulated and they fill in the gap by producing abundant fibrous connective tissue. If the density of this new tissue is relatively extensive it is usually replaced by normal skin layer over time. A result of a persistent scar remains, when the mass of new tissue is relatively extensive it is associated to cell damage and the fibrous tissue remains.