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Scar Revision

Scars can be surgically revised after at least 2 months of healing. The procedure can be performed under local anesthesia. The widened scar is excised and the normal skin edges are brought together. The main reason scar revision months after original surgical repair works better than the surgical repair is wound tension. The original wound tension has relaxed and the skin has stretched. Scar revision involves minimal tension of repair and results in narrower scar.

Another reason scar revision results in smaller scar has to do with the depth of surgery. Deep incisions create a vertical contracture at the incision line, causing a crease. Scar revision is performed in a shallower plane that results in less crease formation.

Scar revision can also be done to re-orient the direction of the scar if poorly placed originally. Z-plasty is a technique that accompishes this and is particularly useful for webbed scars in areas of concavity - corner of the eye near the nose, nasal ala and cheek crease. In some cases, scar revision corrects the mismatch of thicker and thinner skin at the repair line by thinning the thicker skin.

Time and waiting can continue to improve the appearance of scars for up to 9 months. Your reconstructive surgeon would be able to tell if scar revision is warranted prior to the completion of all healing. If it is obvious that scar revision will be eventually needed, then it should be preformed as soon as the surgeon is comfortable with the timing of the revision.

Nasal Tip Scar Revision: Left Image shows nasal tip scar defect following Mohs surgery to
remove skin cancer and reconstruction. Right Image is 10 weeks post scar revision of nasal tip