What is Scar Revision?

A scar is the body’s natural response to injury or surgery. Patients often ask if it is possible to perform surgery on the skin without a scar. While there is currently no such thing as scar-less wound healing, plastic surgeons use special techniques during surgery and after surgery to optimize the appearance of scars. A multitude of factors contribute to how a scar heals, some of which cannot be controlled by the surgeon. Some of these factors include the location on your body to your individual genetics. When healing has not been favorable, scar revision can be performed to improve the quality and appearance of an existing scar. Surgery is meant to minimize the scar so that it is more consistent with your surrounding skin.

Many different types of scars exist, including hypertrophic scars, keloids, and contractures. A hypertrophic scar is an area of thickened scar that develops at a wound site. They are often thickened and can be dark (hyperpigmented) or light (hypopigmented) compared to the surrounding skin. Keloids differ from hypertrophic scars in that they extend beyond the boundaries of the wound or incisions. Keloids can be itchy and/or painful, and occur more commonly in areas under tension and in people with more pigment in their skin. Contractures can occur when an incision or wound crosses a joint, such as in a finger, across the elbow, or across the knee. These types of scars can be problematic because they can restrict movement of the joint.

Scar revision can be performed at any age and is a good option for you to consider if you are bothered by the appearance of a scar, or if you have symptoms associated with the scar such as pain, itching, or restricted movement. There are many different ways to revise a scar. During your consultation, Dr. Hewell and/or Dr. Fischer will evaluate the scar in detail and discuss all of the scar revision techniques with you.

About the Procedure:

There are many different ways to revise a scar including topical modalities, injections, resurfacing techniques, direct excision, skin grafting, and tissue expansion. After years of training in plastic surgery, including caring for hundreds of burn patients, both Dr. Hewell and Dr. Fischer have a high level of experience in all scar revision techniques. The most common techniques for scar revision include dermabrasion, a mechanical buffing of the outer skin surface, and direct excision of the scar with closure. The technique that is ideal for your scar revision will be decided at your consultation.


If you are a smoker, you should stop smoking to improve your body’s healing potential. Dr. Hewell and Dr. Fischer ask that you avoid aspirin, ibuprofen, herbal supplements, and other non-steroidal anti-inflammatories (NSAID) drugs two weeks prior to surgery as these medications can increase bleeding. If you have diabetes, good blood sugar control is important to help maximize healing and minimize the risk of infection.

Most scar revisions are performed under local anesthesia. More significant scars, or scars in sensitive locations can be revised under intravenous sedation, or general anesthesia for very large areas of scarring.

Strict adherence to all postoperative instructions will help you achieve the best possible result after scar revision. Dr. Hewell and Dr. Fischer will review incision care with you following surgery, and discuss other important factors such as exercise guidelines and sun protection.

Procedures 3



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