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What is scar revision?
Facial scarring is a very delicate subject for many people. Children, many times do not know
how to verbalize their discomfort and men are taught to not say a thing, because a "real" man
would just take it like a man. Facial scarring leaves deep emotional scars that are unseen,
but are also a cause of unintentional emotional issues that perhaps do not surface till later
in life.
Many plastic surgeons deal with this type of scar revision. It is not a simple aspect to
cosmetic surgery, but ultimately it is said to be the most gratifying. The issue with scar
revision is that it is done with incisions in mind - the whole point of scar revision is to
avoid incurring any more scar, and to eliminate or reduce the already existing one. Incisions
are difficult to hide, and in some cases the incisions will be even more difficult to deal
with when the scars are on the cheeks or jaw line.
Scar revision is a particular surgery that inherently leads many to believe that it is
immediate. Impatience is one of the aspects of the procedure. The heavy emotions associated
with scar revision cause many to want to see results immediately; often times the surgery is
part of a series of procedures that must be done over time to achieve the optimal outcome.
Often times it is children and young adults that come in for this type of procedure. Injury,
accidents, or acne are the major concerns, and are sometimes difficult to deal with. It is
optimal to work with younger patients because they tend to heal quickly, but in their ability
to heal quickly, they also have the tendency to heal with additional scarring. Telling a
younger patient that this is how nature works, and that the original scar will be gone, and
this new one will fade over time, is sometimes not too easy.
It is difficult to assess the how the healing will occur, but with the innumerable variables
involved, many times the most careful of repairs will not get you the most acceptable of
results. In treating an initial injury, doctors are unsure of how the tissues will heal. Lost
tissue may have to be grafted, and wounds may have to be closed under tension. These factors
may increase the potential of scarring.
There are many options to help in healing scars, and surgery should only be an option when
those have been exhausted.
Massage therapy: An old wive's tale, but one that has shown consistent results. Use of Vitamin
E and Cocoa butter have shown improvement of scars of all kinds. Many women use this on
children and themselves during pregnancy.
Cortisone Drugs: Topical cortisone is used in many cases to help in healing. In many cases
this heals scars so that surgery is not required.
Re-excision: Many times if a scar is re-excised, it will heal without much tension. Tension
is what creates new scars- so avoidance of that may help in the healing process.
Other options to surgery have been are dermabrasion, collagen implantation, silicon pressure
therapy and wound excision. These should be administered under the strict supervision of a
doctor or a plastic surgeon. There are no guarantees in plastic surgery, and especially in
scar revision therapy.
As mentioned, in dealing with scars, there is a very specific area that one operates in,
because the scar is the original reason for the procedure. It is important to remember that
anytime an incision is made, a scar may result, regardless of your age or health condition.
Your skin will predetermine how a scar will be dealt with, which has no bearing on the skills
of your surgeon. There are no guarantees in this type of procedure, and in no case will
surgery eliminate a scar completely. In almost all patients, it will minimize the scar. There
are situations in which the scar has been made worse. Although pretty uncommon, it is a risk
that you must accept.
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