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Scar Revision and Skin Surgery

Unsightly, disfiguring scars or defects can be disconcerting and often devastating to a person’s self-image. In addition to scars, other blemishes or defects that may be removed or improved with carefully planned plastic surgical techniques include moles, skin tumors (cancers), birthmarks, and cysts. These lesions may be partially or completely excised with surgery. Dr. McCollough uses cutting-edge scar revision techniques to remove or diminish existing scars or blemishes.

Scars Are Usually Unsightly
Because They May:

  • Be wide
  • Be longer than one inch
  • Cross natural creases or facial contour lines
  • Be elevated above the adjacent skin
  • Be depressed below the adjacent skin
  • Be a different color than adjacent tissues

If any or all of these characteristics are present, improvement in any one of them should make the scar(s) less conspicuous. Correction of two or three of these factors can often result in dramatic improvement of the appearance (and sometimes function) of the scar(s).

What Is Scar Revision & Skin Surgery?

Surgical treatment for deep scars and skin defects requires incisions to remove the existing scar or blemish. Each incision made into the skin, regardless of where it is placed, who makes it, for what purpose, or whether it is deliberate or accidental, heals in the same manner as any other cut; that is, it produces scar tissue. It is Nature’s method of healing.

This is often forgotten or ignored by individuals who think that a “plastic surgeon” can make an incision and leave no visible scar and that he can, in fact, fully eliminate existing scars. In reality, the surgeon’s expertise and goal is to replace an existing unsightly or disfiguring scar with a better scar, one that is more narrow, more level, blends with the surrounding skin surface, and which causes no contracture or pull on the surrounding structures; in short, one which is as inconspicuous as possible.

Scar Revision

Before & Afters

*Each patient is unique, and individual results may vary.
See More Before & Afters

Patient Testimonials

If you’re reading reviews wondering what to do….. call them and set up a consult with Dr. McCollough! You’ll be glad you did.

-S.L.

Setting Realistic Expectations

Possibly conditioned by what they see on television and in the movies, many people expect this final result of scar revision immediately; and tend to become disappointed and troubled because they have to wait months for the “maturation” of their scars. Maturation is the continuing change in appearance that all scars go through until they reach a state where no further change will occur.

Maturation of scars may take from 6 to 18 months, sometimes longer, especially in young children. Initially, a freshly repaired incision of scar usually looks improved. Then, it becomes reddened, possibly somewhat raised above the surrounding skin, and frequently is hard or lumpy.

Unless the scar is frequently stressed by stretching the surrounding skin, the firmness and red color lessen and should disappear, leaving a softer scar that is more level with and somewhat lighter in color than the adjacent skin. Oftentimes, this process of healing can be expedited by strategic injections of cortisone into the healing scar.

Patients seeking scar revision should be emotionally prepared to accept several facts:

  • Removal will result in another although, hopefully, improved scar.
  • The final appearance will not be evident for 6 to 18 months.
  • More than one procedure may be required.

The McCollough Scar Revision Approach

When removing an existing scar or blemish by excision, the surgeon makes every effort to place the line of incision as nearly as possible in, or parallel to, one of the normal crease lines of the face or body. Sometimes, it may be necessary to change the direction of a scar so that it will follow these anatomic lines. Excision of large unsightly scars, birthmarks, or blemishes may require multiple operations over a period of time (so-called serial excisions). Occasionally, it is necessary to shift surrounding tissue to fill a defect, or rarely, even resort to skin grafting.

When to Consider Scar Revision?

Most people with recent scarring want to repair immediately; however, scar revision, except in selected cases, should not be undertaken too soon. The passage of time is the best, the kindest, and, in the long run—in some cases, accompanied by strategic injections of cortisone—the simplest treatment to give to any scar of recent origin since most will undergo improvement if given enough time to do so, often 6 to 18 months.

Only after the scar has become soft and white is it considered “mature.” A decision regarding a second stage revision may be delayed until this time has elapsed. However, scars that cause distortion of normal structures (eyebrows, lips, eyelids, nostrils, etc.), those that spread widely or produce deformity by contraction, and “U” or “J” shaped scars may be repaired earlier because little or no improvement in the basic problem can be anticipated with time.

Late-Stage Scar Revision with Dermabrasion

When the skin has an irregular or uneven texture from acne scarring or from previous incisions or injuries, a Stage II or III dermabrasion may provide additional improvement. The technique of dermabrasion is similar to sanding a scratch from a wooden table in that the work is done on the elevated areas to take them down closer to the level of the defect. When successful, this diminishes the high-low junctions responsible for casting shadows when light strikes the face from an angle, leaving the skin somewhat smoother and tighter than before. Dr. McCollough recommends that anyone contemplating scar revision surgery read the chapter in his book, THE APPEARANCE FACTOR, which can also be downloaded, free of charge, by visiting www.mccolloughplasticsurgery.com and clicking on the book’s cover on the home page.

Schedule Your Consultation with a
McCollough Plastic Surgery Surgeon

Dr. McCollough is a distinguished double board-certified facial plastic surgeon, certified by both the American Board of Facial Plastic and Reconstructive Surgery and the American Board of Otolaryngology-Head and Neck Surgery. At McCollough Plastic Surgery, we believe that looking your best can pave the way to enduring health, happiness, and prosperity. Our institute, clinic, skin center, and total health spa is a trusted destination for those seeking a comprehensive transformation of their appearance. Contact us today for your consultation — you can trust us to guide you on your journey to making your scar—or scars—look as good as possible.

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