Scar Revision Surgery

Most scars fade and flatten over a year or so. Some don't. A burn scar can tighten across the elbow until you can't straighten it, and a keloid on the earlobe after a piercing can go on growing long after the ear healed.

Scar revision doesn't erase a scar. It replaces it with a better one: narrower, flatter, closer to your skin colour, or turned to lie along the natural creases of your skin where it shows less. Depending on the scar, the surgeon may cut it out and close the skin carefully in layers, break a straight line into a zigzag (a Z-plasty or W-plasty) to lengthen a tight scar and disguise it, or bring in a skin graft or flap when there isn't enough skin to close the gap.

The new scar goes through the same healing as the first. It starts red and slightly firm and settles over 12 to 18 months, so the result is judged at about a year, not when the stitches come out. Most people end up with a scar that is much less visible. Keloids are the exception. They often return, even after careful surgery, unless the operation is followed by injections or other treatment.

Scar reduction is part of the work of our skin and hair department, where dermatologists try non-surgical treatment first. Larger scars, including burn and injury scars, can be assessed by our plastic surgeon, Dr. Vishvendu Gaur.

Revision is usually considered once a scar has matured, at least 12 months after the injury or operation, and non-surgical treatment hasn't done enough. Scars that restrict movement may be treated sooner.

The wound heals in a couple of weeks, but the scar keeps changing for a year or more, and what you do in that time affects the final result.