The skin is the largest organ in the body, and serves as a protective barrier for the internal organs. In this protective capacity, the skin is often exposed to harsh environmental elements, and is at an increased risk of sustaining injuries. When a trauma or injury to the skin occurs, the body responds by producing scar tissue—a fibrous tissue comprised primarily of collagen, a protein that stimulates the production of new, healthy cells to repair the damage the skin has sustained.
A visible scar is formed when collagen levels at the wound site exceed the needs of the damaged tissue. Just as wounds vary in terms of depth, location, size, and scope, so do the scars that form around them. There are four general categories of scars:
- Discoloration and Surface Irregularities: this category includes acne scars and scars caused by minor injury or previous surgeries. Scars in this category do not cause physical discomfort, nor do they impair the body’s ability to function normally.
- Hypertropic Scars: raised, red and potentially painful clusters of star tissue that form around the wound site. These scars sometimes expand in width over time, and may be lighter in color (hypopigmented) or darker in color (hyperpigmented) than the color of the patient’s healthy skin
- Keloid Scars: scars in this category tend to be larger than hypertropic scars, often extending beyond the edges of the original wound. Keloids have the potential to pucker, and may be itchy or painful.
- Contractures: contractures occur when a wound crosses a joint, or when patients experience a substantial amount of tissue loss (as with a severe burn) and the skin and underlying tissue pull together during the healing process, thereby contracting the skin and restricting movement of the adjacent area.Scar revision procedures are designed to minimize the appearance of a scar so that it blends in seamlessly with the surrounding skin tone and texture. The technique employed during your scar revision procedure will depend upon which of the aforementioned categories your scar falls into.
SCAR REVISION PROCEDURAL DETAILS
During your initial consultation, Dr. Goravanchi will examine the type, size, severity and location of your scar in order to determine which revision technique (or combination of techniques) will best improve the appearance and condition of the scar. The primary scar revision techniques include:
- Topical Treatments: tapes, gels, or external compression to facilitate wound healing and closure
- Injectable Treatments: steroidal-based compounded may be periodically injected at the wound site to decrease collagen build-up and to improve the appearance of the raised scar tissue
- Surface Treatments: this treatment category includes dermabrasion, laser/light therapy, chemical peels, and skin bleaching agents, which all serve to minimize uneven pigmentation and to soften surface irregularities by removing the outermost skin layers, or by altering the surface of the skin and allowing healthy skin to form at the wound site
- Surgical Treatments: appropriate for deeper scars and for scars that are impairing the patient’s mobility, surgical scar revision techniques may include complex flap closure, pharmaceutical tissue substitutes, or tissue expansion (used as an alternative to skin grafts)