Board-certified, plastic surgeon, Dr. Roland in New York, NY, understands the cosmetic crisis and painful movement restrictions that can be caused by scars. He believes that scar revision is important for individuals who are sensitive about their appearance and who desire to improve severe and unattractive scars, especially on the hands or face. Scar revision techniques are used to narrow, fade, conceal and improve scarring caused by an earlier injury or surgery.
There are a number of factors that Dr. Roland uses to determine the most effective and appropriate scar revision treatment for each patient, and these factors include:
- Nature and type of injury
- The body’s healing ability
- The wound’s size and depth
- The blood supply within that area
It’s important to understand that all scars are permanent. While scar revision can’t completely remove the scar, revision is used to improve its appearance. There are different treatments and techniques that are used for different types of scars. Scar revision is particularly beneficial to those with cosmetically altering scars on sensitive areas such as the face and hands.
Scar Revision Procedure
Collagen is a tough and fibrous protein that is used by the body to build and restore skin after a wound has incurred. Keloid scars are thick, itchy, puckered tissue that occurs when excess collagen is produced by the body. This red or dark scar tissue expands beyond the parameter of the wound after it has healed. Keloids can occur in any area on the body but are most commonly experienced on the earlobes, or can also be consequence of a poor healing from a breast augmentation surgery. Dr. Roland may treat this type of scar with steroids or when necessary with an outpatient surgical procedure that is completed under local anesthesia.
The tough and fibrous tissue is removed during a scar revision treatment with an incision and is then closed with one or more layers of sutures. Patients commonly return to work within two days, and the sutures are removed in a few days. A skin graft may also be completed.
Dr. Roland will review the patient’s history and develop a strategy for limiting the possibility of the development of another keloid scar in that area. A pressure garment, steroid injections or the application of steroids to the wound during surgery may be considered. Keloids caused by excess collagen are persistent, and a plan for ongoing supervision of the incision may be recommended.
Dermabrasion is a non-surgical treatment that may be used to soften and smooth a facial scar. This treatment can’t erase or remove the scar, but it can leave a smoother surface that blends the scar. Dr. Roland may recommend the surgical removal of a large facial scar with a fine, thin incision that will minimize the appearance of the scar.
Z-plasty Scar Revision Surgery
The z-plasty procedure is typically completed with the use of local or general anesthesia. This is best on hypertrophic scars. This type of scarring can form a contractor that may restrict joint movement. These scars are frequently confused with keloids because of some similar features. They too are thick, raised and red in color, but they remain within the exterior boundaries of the wound or incision.
Z-plasty surgical scar revision is used to reposition a scar to a less noticeable area where it is concealed in the creases or natural folds of the skin.
Dr. Roland has experience with hypertrophic scars and may recommend z-plasty scar revision when a scar has not improved with the use of steroids or injections. The z-plasty procedure removes the excess, raised scar tissue and places the incision in a less visual position.
Several incisions are placed on each side of the scar to create a small triangular flap of skin. These flaps are rearranged and interlocked to conceal the area of the scar. Steroids may be prescribed by Dr. Roland to be used during the surgery and possibly after the surgery to help the new incision heal with limited scarring.
Skin Grafting and Flap Surgery
- Severe injuries
- Injuries resulting in the loss of a large patch of skin.
- Contractures – A scar can form in the area of an injury that pulls the skin’s edges together as it heals is called a contracture.
Burns, severe injuries, those injuries that result in the loss of a large area of skin and contractures may produce cosmetic concerns and affect tendons and muscles that result in restricted movement. Skin grafting and flap surgery may be recommended for these types of scars.
Skin grafts and flaps are more serious forms of scar revisions and are usually completed in a hospital setting and followed with inpatient care. The area that is treated may take weeks or even months to completely heal. It may be necessary to wear a bandage for up to a year after a graft or flap surgery.
Grafting uses skin from another area on the body to treat a scar. Flap surgery uses the healthy skin adjacent to a scar to conceal it. Skin grafting and flap surgery are used to greatly restore and improve the function of a scarred area, but the cosmetic results may not be as successful. Dr. Roland will discuss the expected cosmetic results with you, prior to surgery, along with any risks and benefits. Physical therapy may also be used, after the surgery, to restore movement and function to the area.
Preparing For The Initial Scar Revision Consultation
Visit board-certified, plastic surgeon Dr. Roland for a consultation where he will examine your scar and discuss possible scar reconstruction methods with you. Come ready to listen with healthy and realistic expectations. Plastic surgical scar revision results are not typically grandiose and it is important that you understand the best possible results, the risks, and benefits of the treatment, prior to surgery. Share any concerns with Dr. Roland along with your hopes, desires and expectations. Don’t hesitate to ask questions and discuss any concerns.
Commonly Asked Scar Revision Questions
What are the Benefits of Scar Revision?
Scar revision is used to reduce the appearance of scars created by an injury or previous surgery. Severe or unattractive scars may be treated with different scar revision techniques to narrow, fade or improve the appearance of the scar. Scar revision may be particularly beneficial for individuals with facial scars, scars on their hands or in other cosmetically visual or sensitive areas. The scar can’t be completely removed but it can be improved, moved into a crease of skin or concealed with grafting or flaps.
Who is a Good Candidate for Scar Revision?
Good candidates for scar revision are seeking to improve the appearance of an unattractive scar, do not smoke, are in general good health and have realistic expectations that they have discussed with board-certified, plastic surgeon, Dr. Roland. Good candidates also have healthy and realistic expectations and are aware that the scar’s appearance will be improved but not removed.
During a thorough consultation in his NYC office, Dr. Roland will examine and evaluate the scar to determine the best technique to improve its appearance.
Will Insurance Cover Scar Revision?
Insurance companies generally do not cover the cost of plastic surgery, because it is categorized as a cosmetic option. However, when the scarring is due to injury, or if it will improve your ability to function, it may be partially or completely covered. Call your carrier to discuss your policy coverage and you can also speak with office staff about available financing options.
How is Scar Revision Completed?
Dr. Roland performs different scar revision techniques. In some cases, the scar tissue is surgically excised and a new incision is made. Flap surgery and skin grafts use healthy skin tissue from an adjacent or different area on the body to cover the scarred area. Z-plasty scar revision surgery repositions the scars to less noticeable areas such as creases or natural folds in the skin.
Local anesthesia, sedation or general anesthesia is used for different techniques. Dr. Roland performs scar revision in his New York, NY, office or in another fine surgical center or hospital within New York City.
Scar Revision Risks
Scar revision is generally safe, but there are risks with any surgical procedure. Excessive bleeding, infection, a poor reaction to anesthesia or the reoccurrence of a scar are possible risks. Dr. Roland will discuss any risks with you during a consultation as he reviews your current health, your family history, any potential complications and your prior experiences.
You can significantly reduce surgical risks, and you can experience the full benefits of your scar revision when you choose board-certified Dr. Roland to complete the surgery and carefully follow all before and after surgical instructions.
What is Scar Revision Recovery Like?
Scar revision recovery is dependent on the particular technique used by Dr. Roland. After most revisions, some swelling, bruising and discomfort are experienced. If discomfort is experienced, medication can be used to bring relief. The treated area may appear more swollen and red immediately following the surgery, but this will diminish and fade into a fine line. Patients typically return to work within one or two weeks.
Dr. Roland does pro-bono work with the Devino Nino charity providing reconstructive surgery to needy individuals in the Dominican Republic. His charity, Vanity 4 Humanity, also provides aid to individuals in underprivileged countries, throughout the world, treating women with breast cancer deformities. It is his compassionate care and extensive experience that brings patients to his New York, NY, office in the Manhattan area.
We invite you to call (212) 744-9400, or click here to schedule a Scar Revision consultation with Dr. Roland in New York, NY, today.