Facial Scar Revision
Facial scars can be a source of real emotional discomfort. Whether they are the result of burns or other injuries, acne, or previous surgery, they can make us fear that people won’t look beyond them to discover the person within. Some scars even affect facial muscles and inhibit expressiveness. Fortunately, however, new technologies and treatments are providing more ways than ever before for making scars less visible.
There are actually several kinds of scars. Keloid scars are irregular (and often itchy) tissue growths that extend beyond a wound site. Hypertrophic scars are raised, thickened clusters that develop within the wound area. Contracture scars are formed when burns or other injuries destroy large tissue patches and pull at the skin edges. Different treatment approaches—or combination of approaches—may be used for different types of scarring, and Dr. Swenson will discuss with you what is most appropriate in your situation.
Are You a Candidate for Scar Revision?
If facial scarring causes you anxiety—or impedes the flexibility of your facial features—you may benefit substantially from scar revision. The type and extent of your scars, your skin color, your age, and skin elasticity can affect treatment, and if your scars are the result of injury, it’s generally advisable to let them heal for a year before revision surgery. Dr. Swenson will explain your options and what results you can realistically expect.
What to Expect
Minimizing scars must be a highly individualized process, and it may involve more than one procedure or technique. In some cases, it may start with a topical, injectable, or surface treatment—see Chemical Peels and Skin Resurfacing. Surgical treatments are aimed at removing or repositioning the scar tissue. With Z-plasty, scar tissue is removed and small flaps of skin on either side are used to cover and adjust the scar area within natural facial creases, making it less noticeable. Flap surgery is more complicated, using skin and underlying tissues from a healthy area to cover the scar site; the flap may still be attached to its original blood supply, or it may be surgically attached to blood vessels at the new location. Skin grafts transfer healthy skin from one part of the body to the wound site; where there’s not sufficient healthy tissue, man-made tissue may be used. Sometimes tissue expansion is an option. A balloon-like device is inserted under the skin next to the scar and gradually filled with a saline solution, causing the healthy skin to expand. The scar tissue is surgically removed and the newly expanded skin is used to cover the area.
Most treatment is done on an outpatient basis using either local or general anesthesia, while few procedures such as complex flap surgery may be performed under general anesthesia and require a hospital stay. The type and extent of surgery will impact recovery time, but swelling and bruising are to be expected for at least the first week or two. Cold compresses may be suggested, along with elevating your head for sleeping. A bandage may be applied to support the surgical area for a period of time. Dr. Swenson will provide specific instructions for easing discomfort and caring for the skin. The full results of your surgery will unfold over the coming months as the surgical scar completely heals and fades.
Insurance may cover reconstructive surgery necessitated by injury. Cosmetic scar revision usually isn’t covered; check with your insurance carrier to be sure.