Tag Archives: cosmetic surgery for scars

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.

    Minimizing Scars in Hair Transplant Surgery

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    The modernization of hair restoration has made it an option for many men. The scarring from follicular unit transplantation which is a natural permanent solution to hair loss is a concern for many patients.
    Fortunately a number of techniques have been developed to minimize donor scarring when using a strip excision during this surgery, as well as, post surgical solutions that can be done even years later.
    Linear Follicular Unit Transplantation Scar
    Surgical Solutions

    Solutions that a surgeon can utilize during the procedure include:
    • the use of tumescent anesthesia
    • undermining
    • absorbable sutures
    • buried sutures
    • staples, and
    • trichophytic closures.

    These advances in minimizing scarring makes FUT one of the best hair transplant treatments for men.
    Scar minimization from the donor incision is an important component of a successful hair transplant procedure. A fine donor scar gives the patient more flexibility in hair styles post surgery. When the scar is fine the close cut military type hairstyles chosen by men and women can still be worn after hair restoration.

    Four aspects to having the donor incision heal in a fine line:

    1. placing the incision in the proper location
    2. using the correct donor strip dimensions
    3. removing the strip without damage to the tissue
    4. closing the donor area with impeccable surgical techniques

    Positioning the Donor Incision

    The ideal placement of the donor incision is in the mid-part of the permanent zone located in the back and sides of the scalp. This area lies in a band that starts above the occipital protuberance (the bump felt in the middle part of the back of the scalp) and extends to either side in a gentle, upward sloping curve that follows the contour of the scalp. If hair is harvested below this region, there is a greater risk of scarring from the wound stretching, since the incision will be too close to the muscles of the neck. If the incision is above this area, the hair may not be permanent and may fall out as the baldness progresses.

    Size of the Donor Strip

    The length of the donor incision is determined predominantly by the number of follicular unit grafts required for the hair restoration, the width (height) of the donor incision depends upon the patient’s scalp laxity. This is a genetic attribute of the patient’s scalp that must be carefully measured by the hair transplant surgeon during the initial evaluation. With good scalp laxity, a wider strip may be harvested from the donor area without the risk of scarring (although patients with very loose scalps may be at increased risk of a wide scar If the scalp is too tight, taking a normal size strip may be impossible.

    If the strip width is too narrow, the incision will need to be unnecessarily long to obtain an adequate amount of donor hair. If the strip width is too wide, the risk of having a widened scar will be increased significantly. Expert clinical judgment, acquired over years of experience, is needed for the surgeon to consistently set the appropriate length and width of the donor strip and achieve the minimum possible scar.

    Laser Technology in Scar Revision

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    Advent of Laser Technology in Scar Revision


    Who doesn’t have a scar? The natural healing mechanism following injury or surgery most often leaves some level of scar. Many individuals bear no adverse reaction to scarring. Of course the location of a scar and its severity can make all the difference to some people’s self image. While the scar appearance is usually quite acceptable, in many other instances the scar can raise, thicken, or become red. This type of scarring is called ‘hypertrophic scarring.’ Some individuals may even develop an extreme form of scarring called a ‘keloid.’

    Laser Scar Revision

    Laser technology Advances Scar RevisionIn recent years the use of lasers in medicine has enjoyed rapid development in medicine. Doctors and researchers are experimenting with the devices in a wide variety of procedures, like opening blocked coronary arteries and reshaping the cornea of the eye to correct poor vision, dissolving kidney stones and in scar revisioning.

    These advances in medical laser technology allows for easier revisioning treatment of scars. Applied in the right cases laser scar revisioning can have remarkable success and can bemore effective than ever.

    Lasers are used in two primary ways in scar revisioning:


    • to treat the surface color of the scar
    • to go deeper and break up the collagen bunches that cause the scar

    The result renders scars smoother, more evenly colored. The application of these new laser treatments appears limitless as doctors and researchers fine tune the levels of laser frequency for different medical applications. Lasers are effective on scars from accidents, dog bites, cesarean sections, orthopedic surgery, plastic surgery and skin grafts have proven quite successful and a large cross section of patients. It is important to note however because scarring is a highly individualized healing process that thorough medical consult is the best option. New laser therapies have ever proven effective on burn scars.

    Laser Scar Revision Results


    Scars cannot be completely removed from any treatment. Scar revision is meant to obscure the scar by making it blend better with your skin in colour and texture.; the more T the scar to blend s naturally with the surrounding skin The better the results. If the scar is uneven in texture, laser scar revision will help smooth out the scar so that the area is flatter. Additional treatments will continue to improve these effects.

    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.

    An Overview of Burn Scars

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    Burn Reconstruction

    Burns caused by heat, chemicals and fires can result in the most traumatic types of scaring. The severity of burns is classified as first, second and third degree burn. This designation is based on the dept of damage to the outer and deeper layers of the epidermis (skin) and dermis (inner skin) tissue.

    Burns can leave patients with severe physical disfigurements.
    The emotional trauma can often exceed the physical trauma as self image is an integral part of an individual’s self esteem. Scar revision surgery for all types of scars is often elected to positively affect the patient’s emotional well being.

    Burn treatments usually involve skin grafting and cosmetic reconstruction, and may be performed in an emergency facility or later on. These treatments also focus on restoring function to the burned skin to reduce the risk of complications such as loss of mobility or a loss of one of the senses.
    Acute Burn Care

    Any type of burn on the skin requires immediate medical attention to stabilize the patient, clean the wound and reduce the risk of complications such as infection, scarring, breathing problems and limited bone and joint mobility. Initial burn care focuses on assessing and treating the initial burn symptoms, prevents infections and other potential further risks. Additional treatment may be required at a later time for skin reconstruction. It is also important for patients to remain hydrated after a burn, so fluids may be administered intravenously to prevent dehydration.

    Comprehensive burn care that includes an evaluation of:
    • the burn and any related conditions
    • thorough wound care
    • proper dressing
    • pain mitigation through medications
    • emergency surgery as may be required.
    Burn Scars

    Most burns will usually leave a scar,The appearance of the scar depends on the size, location and severity of the burn. Scars usually become less noticeable over time, however when they scar is obvious patients seek reconstructive treatment to improve their appearance of scars that are physically unattractive or disfiguring. Reconstructive procedures are most often performed after the burn has fully healed, which may be nine months to a year after the original injury.

    Scar reconstruction is usually performed through an outpatient surgical procedure that may involve skin and tissue grafts, skin flaps or injectable fillers to restore a more natural appearance, while also correcting any functional problems caused by the scar and improving the patient’s self-confidence as well.

    Contractures

    A contracture is a complication of burn scarring that involves a tightening and thickening of the burn scar that in turn restricts movement of the affected area. It is important for patients to take precautions to prevent contractures from occurring, by exercising, wearing a splint and continuing to promote everyday activities that require movement.

    Treatment for contracture scars often involves surgery to release the contracture and restore normal movement to the skin. A skin flap or graft may be used to restore the appearance of the skin in the treated area, while also improving movement and flexibility that may have been affected by the contracture. Physical therapy will often be needed after surgery to stretch the joints and restore movement and function.

    Scar Revision Insurance Coverage

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    The unpredictability of scars is a part of the human experience. Many scars are unobtrusive and we often forget about them. It is not uncommon especially among machismo male culture to embellish the history of a scar as a rite of passage. Unfortunately for many people a scar can be a debilitating phenomenon emotionally and physically. It is for these reasons that some insurance programs will cover scar revision for patients.

    The formation of a scar depends as much upon the way your body heals. Likewise your individual healing process combined with the surgeon’s skill affects the success of a scar revision surgery outcome.

    The factors that affect scarring are:
    • the size and severity of the wound,
    • its shape and direction
    • the original color and thickness of your skin
    • the blood supply to the injured area.

    The merits as to the need for plastic surgery are a highly personal decision, and are different for each person.

    Types of Scars
    • Stretch Mark Removal
    • Keloid scars
    • Hypertrophic scars
    • Contractures

    Common Scar Revision Surgeries
    • Z-plasty
    • Flap surgery
    • Skin grafting

    Medical Insurance May Cover Cost of Scar Revision

    Scar revision cost may include:
    • Surgeon’s fee
    • Hospital or surgical facility costs
    • Anesthesia fees
    • Prescriptions for medication
    • Post-surgery garments
    • Medical tests

    Though many health insurance plans will not cover scar revision surgery for cosmetics alone. If the surgery if for complications related to the injury and the scar can be revised through the procedure it can be covered. Some policies also include coverage for scarring that is limiting body functionality. You must carefully review your health insurance policy.

    It is impossible to remove a scar completely. However, plastic surgery can often do much to lessen the severity of a scar, making it less noticeable by applying or injecting steroids or through scar revision, a commonly used surgical procedure. Many people assume that as elective surgery it has to be an out of pocket expense. This is not necessarily true. Check with your medical insurance provider to see if this is the case; don’t assume. Many people improve their self image and quality of life through scar revision surgery.

    Scar Revision from Breast Augmentation

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    All surgeries are going to leave a scar. The leading cosmetic surgeons who specialize in breast augmentation are good at reducing the visibility of the scar. The very best surgeons make sure only very close scrutiny reveal the signature of their work. The techniques for revising scars very and are applied as the surgeon deems best for the patient and their particular case. Often women undergo more than one breast implant surgery. If a woman has suffered from a poor elective procedure the top cosmetic doctors can redo the surgery and also revise the scarring in the same procedure.

    Do breast implants last a lifetime? Women considering breast augmentation ask this question frequently. Breast implants are not made with an expiration date, so you should be able to enjoy the results for many years. However, unexpected issues occur for a certain number of patients. If you think you’re experiencing a problem with your breast implants, call us to schedule a consultation and Dr. Hess will see you as soon as possible.

    Reasons for Revision Breast Augmentation
    Problems that occur after breast implant surgery. Most often they are corrected with a brief revision surgery. Of course, Some of the reasons women seek revision of breast augmentation are :

  • Breast implant rippling
  • Volume adjustment of saline implants
  • Scar revision procedure
  • Change in implant size preferences
  • Switch from saline to silicone implants
  • Areola size reduction
  • Noticeable breast asymmetry
  • Symmastia
  • Nipple ptosis or sagging
  • Breast implant displacement
  • Breast implant rupture
  • Nipple malposition
  • Scar tissue surrounding implant
  • High riding implants

    • Caesarian Section Scar Revision

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    About C section Scar

    Some women may do to emergency or elect to have their birth surgically. This is called a Caesarian Section or most often referred to as a C-section. In this surgical procedure one or more incisions are made through a mother’s abdomen (laparotomy) and uterus (hysterotomy) to deliver one or more babies. This will leave a surgical scar that many woman wish to have revised after the decision not to have any more children. In emergencies often the scar is longitudinal running from just below the naval to the lower abdomen. In elective C section more often the scar is latitudinal just above the pubic bone on the lower abdomen.

    The Video Below is a medical procedure and contains graphic images that may be unsuitable for children and some adults.

    About C section Scars

    • This Cesarean section scar involves a midline longitudinal incision which allows a larger space to deliver the baby. It is not often performed today.
    • The lower uterine segment section is the procedure most commonly used today; it involves a transverse cut just above the edge of the bladder and results in less blood loss and is easier to repair.
    • An emergency Cesarean section is a Cesarean performed once labour has commenced.
    • A crash Cesarean section is a Cesarean performed in an obstetric emergency, where complications of pregnancy onset suddenly during the process of labour, and swift action is required to prevent the deaths of mother, the child or both.
    • A Cesarean hysterectomy consists of a Cesarean section followed by the removal of the uterus. This may be done in cases of intractable bleeding or when the placenta cannot be separated from the uterus.
    • A repeat Cesarean section is done when a patient had a previous Cesarean section. Typically it is performed through the old scar.

      • Regardless of the type of C section performed and the resulting scar they can be treated in a similar way. Tummy tucks are often used to revise or obscure a C-section scar.

    Facial Scars

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    Facial Scar Duress

    The impact of scarring and the disfigurement from it has a tremendous emotional impact on a person. It can be even greater for children who may lack the cognitive and language skills to communicate there distress. Males of all ages are often ingrained socially not to communicate distress over scarring even if it is impacting them in a negative way. Many people undergo unnecessary deformity because either they or their families have failed to deal with their concern over the effects of facial scarring or have failed to seek advice on what can be done to improve the appearance of facial scars.

    Advancement in today’s cosmetic surgery provides more options. The treatment of facial scarring can be the most gratifying thing that a cosmetic surgeon does. Unlike other cosmetic procedures, incisions for revision cannot be hidden. The location of the scar determines the incision but it is the techniques in restructuring the scar that can greatly reduce its appearance and advance a patients self-image and emotional wellbeing.

    Importance of Timing Scar Revision

    Children and young adults are the disproportionately the victims of injury. Their skin tends to heal with more scarring because they heal more rapidly. Although these scars tend to fade with time, it still makes the treatment program more difficult. Furthermore, it makes it much more important to wait before initiating treatment since a scar that looks poor a month or so after injury may continue to greatly improve in appearance for many months. Ultimately, it may be so unnoticeable as to not require treatment.

    Although the repair carried out at the time of injury does influence the amount of scarring that exists after healing, even the most careful repair may not provide a totally acceptable result. When treating the initial injury, one is never sure how tissues will heal. Lost tissue may have to be replaced with grafts. Wounds may have to be closed under tension. These are only some of the factors that tend to promote increased scarring.