Overview
Not all scars heal equally — hypertrophic scars, keloids, widened scars, contracted scars, and those from prior surgery can all interfere with appearance and occasionally function. Scar revision is not a matter of removing the scar entirely — scars are permanent — but of repositioning, resurfacing, or restructuring them so they heal more favorably. Dr. Fern combines surgical excision, Z-plasty and W-plasty techniques, steroid injection, laser, and skin care protocols to achieve the best possible result.
Are You a Good Candidate?
Ideal candidates for scar revision typically present with one or more of the following:
- Hypertrophic or raised scar
- Widened or stretched scar
- Scar crossing aesthetic facial units at an unfavorable angle
- Contracted scar limiting movement
- Keloid requiring combined treatment
- Scar at least 12 months old and fully mature
The Procedure
Dr. Fern's approach to scar revision proceeds through the following steps:
- Scar type and characteristics assessed
- Surgical excision with simple closure for favorable scars
- Z-plasty or W-plasty to break up linear scars and reorient tension
- Laser resurfacing for surface irregularity after surgical correction
- Steroid injection +/- silicone sheeting for hypertrophic or keloid tendency
Recovery
Minor procedures: return to work in 3–5 days. Laser addition: 5–7 days. Sun protection and scar management products throughout the 12-month maturation period.
Frequently Asked Questions
How much improvement can I expect?
Scar revision can produce significant improvement in most cases, but cannot achieve perfection. Results depend on the scar type, location, your skin's healing tendency, and the technique used. Realistic expectations are discussed at consultation.
Is laser or surgery better for my scar?
Surgical revision and laser address different aspects. Raised, irregular surface texture responds to laser. Width, direction, and depth respond to surgical techniques. Often both are used together for optimal results.