Facial Scar Revision

Facial scars may be caused by trauma, acne, or even previous surgery. There are certain characteristics that make a scar on the face more noticeable.

The color of the scar is a trait that may attract attention to the human eye. Hyperpigmented scars or darker scars may be more conspicuous than those that are a fine white line. Patients with darker skin types may have more hyperpigmented or hypertrophic scars or even keloidst

The texture of the scar is another feature that may make a scar more noticeable. A depressed scar or raised scar that is uneven with the surrounding skin will attract more attention than one at the same level as the surrounding skin. In addition, the scar width is also an important feature. A fine line is preferable.

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Lastly, the scar direction is important in scar camoflauge. Scars that are oriented along the relaxed skin tension lines are less noticeable. These are lines that correspond with many of the wrinkles on our face such as the lines across the forehead, the crow's feet, or cheek smile lines. A scar that runs perpendicular to these creases is more noticeable and apparent versus one that runs parallel.

There are many ways to perform a scar revision depending the size, orientation, width, and color of the scar.

Scars that are simply hyperpigmented may respond well to steroid injection or laser treatment. These are procedures that can be easily performed in the office.

Scars that are under tension or oriented in the wrong direction respond well to Z-plasty. This procedure removes the original scar and rearranges the surrounding skin in a "Z" pattern. This lenghtens the scar slightly to remove the tension on it, but also reorients the scar in a different direction.

Scars that are very long may respond well to W-plasty or a geometric closure. These procedures also remove the scar but rearrange the surrounding skin with multiple "W's" or shapes to break up the linearity of the scar. This makes it less noticeable.

 

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