Scar Revision

Scar Revision

What is a Scar?

Scars represent the body’s inherent healing response to injury. In an attempt to repair itself and restore lost tissue, collagen and other connective tissue is rapidly produced by cells, also known as fibroblasts, within the skin. Scars can come from environmental injury to the skin (ie. traumatic scars), medical procedures (ie. postsurgical scars), or medical conditions that cause chronic inflammation within the skin (ie. acne scarring).  Although scarring is an evolutionarily adaptive mechanism that allows our skin to interface with a dynamic environment, scars can also be an unwanted physical reminder of an event or a medical condition, and can be perceived as aesthetically undesirable.

What is Scar Revision?

There are many treatment methods to improve the appearance of scars.  Scar revision is the general term used to describe cosmetic and functional scar enhancement.  Surgical scar revision is the most traditional and one of the most powerful methods of improving the appearance of scars. When performed with precision, skill, and experience, the outcome can be superior to results obtained from lasers, microneedling, or dermabrasion.  Proper technique, exquisite attention to detail, a profound understanding of tissue dynamics, and the correct sutures must be utilized to ensure minimal visibility of the scar.  Surgical scar revision may not be appropriate for all types of scars, and is more often used to correct an existing unsightly postoperative scars.

Laser surgery is another commonly used approach to improve the appearance of scars. The exact type of laser utilized depends on the type of scar to be treated. Pulsed dye lasers are often used to minimize red discoloration of early stage scars, while nonablative fractional lasers can be used to homogenize older, white scars.

More recently, microneedling has been found to be a highly effective nonsurgical tool in normalizing the discoloration and textural differences of scar tissue.   This treatment method is utilized when a less invasive option is desired or when surgical scar revision is not an appropriate option.  Microneedling is a highly precise and controlled procedure that works similarly to a fractional nonablative laser, but can be applied to various segments of skin with less concern about blending in with nontreated skin.

Sometimes, scars may require a combination approach that involves multiple treatment modalities.  This is applicable for complex scars with unique characteristics that cannot be addressed with traditional unidimensional methods.  During your consultation, Dr. Tzu will review your medical history, consider any unique characteristics of your scar type and location, and formulate a customized treatment plan, whether it involves a single or combination treatment method, that will optimize the aesthetic outcome of your scar.

Does Scar Revision Hurt?

Scar revision is always performed with a local numbing medicine, whether injectable local anesthesia or a topical anesthesia.  With the proper numbing, scar revision should be a pain -free procedure.  After the procedure is complete, you may experience some mild discomfort that improves over the next several days.

What is the Downtime for Scar Revision?

While the actual downtime depends on the size and extent of the scar and its location on the body, routine scar revisions for small to medium sized scars require no downtime and most people are able to return back to low-impact, office work same day or next day.  However, because scars are by nature the body’s reaction to injury and are activated by tension across the wound site, exercise and strenuous physical activity is to be strictly avoided for a minimum of two weeks for the best cosmetic outcome.  During your consultation, Dr. Tzu will discuss with you, depending on your individual scar characteristics and the chosen revision technique, the exact amount of time in which you should avoid strenuous physical activity for optimal outcomes.

How Many Treatments are Needed for Scar Revision?

The number of treatments will depend on the specific treatment(s) recommended for the scar.  Laser scar revision and microneedling typically involve multiple sessions, ranging from 3 to 6 sessions on average.  Routine surgical scar revision may sometimes be as definitive as one session, or be part of a more complex serial scar revision in which multiple sessions are required.  During your consultation, Dr. Tzu will evaluate the characteristics of your scar, your desired endpoint, and discuss the number of expected sessions for optimal improvement.

Why Choose Scar Revision at Wall Street Dermatology?

Dr. Tzu is a double board-certified dermatologist with advanced fellowship training in dermatologic surgery and skin reconstruction.  She graduated from one of the nation’s most prestigious programs in dermatologic surgery at the Hospital of the University of Pennsylvania, and has been practicing dermatologic surgery for over a decade.  Her years of experience in skin cancer surgery and reconstruction of surgical wounds stimulated a keen interest in perfecting the appearance of the surgical scar and a profound understanding of the skin’s wound healing behavior and patterns.  Precise placement of sutures and alignment of skin, utilizing the most appropriate suture material, and choosing the appropriate surgical and/or nonsurgical method, all contribute to the perfection-oriented ultimate outcome.

 

Call Wall Street Dermatology to schedule a consultation with us today.

Dr. Julia Tzu

Dr. Julia Tzu is a double board certified dermatologist who specializes in Mohs and reconstructive skin surgery, laser surgery, and cosmetic dermatology. She is one very few dermatologists in the world who has devoted additional years of formalized fellowship training in both Mohs surgery as well as dermatopathology, making her amongst the most highly trained and elite dermatologists.

Address

Wall Street Dermatology: Julia Tzu, MD
Phone: 212-931-0538
65 Broadway, Ste 904
New York, NY 10006

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