of Facial Scars
the skin is in the process of recovering from an injury,
whether the result of an accident, surgery, a burn,
or acne, scarring will occur wherever multiple layers
of the skin have been affected. Once a scar forms, it
is permanent but may be made less visible or relocated
very few exceptions most people are self-conscious
about facial scars. Some people may also experience
diminished functioning of the eyes, mouth, or nose
due to scarring. If you've wondered how facial scar
revision could improve your appearance, your self-confidence,
or your level of facial functioning, you need to know
how scar revision works and what you can expect from
this procedure. This pamphlet can address many of
your and provide you the information to begin considering
facial scar revision surgery.
facial plastic surgery is a result of good rapport
between patient and surgeon. Trust, based on realistic
expectations and exacting medical expertise, develops
in the consulting stages before surgery is performed.
Your surgeon can answer specific questions about your
Facial Scar Treatment For You?
most basic requirement for all surgery is good health.
Other requirements are more subtle and should be carefully
considered in discussion with your surgeon. Expectations
of the surgery and of the surgeon must be realistic.
A person considering facial scar revision must understand
that there is no way to remove scars completely. The
goal is to improve the appearance of the scar either
by disguising it, relocating it, or minimizing its
prominence. Skin color and type, age, and the type
of scarring, are all important factors that must be
part of the discussion prior to surgery.
types of scars respond to different plastic surgery
techniques. Timing of surgery is another important
choice. Some surgeons advise against any scar revision
in cases of injury for a period that might extend
up to a year after the injury. This interval allows
the body enough time to heal fully.
the Decision For Scar Treatment
Whether the surgery is desired for functional or cosmetic
reasons, your choice of a facial plastic surgeon is
of paramount importance. Your surgeon will examine
the scar in order to decide upon the proper treatment
and inform you of outcomes that can be expected from
facial scar revision surgery.
scars require different treatments. For example, severe
burns that destroy large sections of skin cause the
skin to heal in a puckered way. As the skin heals,
muscles and tendons may be affected in this "contracting"
movement. Keloid scars are a result of the skin's
overproduction of collagen after a wound has healed.
These scars generally appear as growths in the scar
site. Hypertrophic scars, unlike keloids, do not grow
out of the boundaries of the scar area, but because
of their thick, raised texture, can be unsightly and
may also restrict the natural movement of muscles
facial scars are unattractive simply because of where
they appear on the face, while others affect facial
expressions. All surgical possibilities will be discussed
in the initial consultation along with risks involved
for each type of scarring. The agreement between you
and your surgeon on how to proceed is a prerequisite
for successful surgery. After you both decide to proceed
with scar revision, your surgeon will inform you about
the anesthesia, the surgical facility, any supportive
surgery options, and costs.
scars are highly individualistic and the patient's
attitude toward scars is so personal, maximum improvement
in facial scars may require more than one procedure,
and more than one technique may be employed.
a scar is of the contracture type, surgery generally
involves removing the scar tissue entirely. Skin flaps,
composed of adjacent healthy, unscarred skin, are
then lifted and moved to form a new incision line.
Where a flap is not possible, a skin graft may be
used. A graft involves taking a section of skin tissue
from one area and attaching it to another, and time
must be allowed following surgery for new blood vessels
and soft tissue to form. Z-plasty is a method to move
a scar from one area to another, usually into a natural
fold or crease in the skin to minimize its visibility.
While Z-plasty does not remove all signs of a scar,
it does make it less noticeable.
and laser resurfacing are methods a surgeon uses to
make "rough or elevated" scars less prominent, by
removing part of the upper layers of skin with an
abrading tool or laser light. Clearly, the scar will
remain, but it will be smoother and less visible.
or hypertropic scars are often treated first with
injections of steroids to reduce size. If this is
not satisfactory, the scars can be removed surgically,
and the incisions closed with fine stitches, often
resulting in less prominent scars.
to Expect After the Surgery
You can expect to feel some discomfort after facial
scar revision surgery. Some swelling, bruising and
redness are generally unavoidable. It is important
for you to follow your surgeon's after care recommendations
to the letter. Though the sutures will be removed
within days after the surgery, your skin needs time
to heal. Surgeons generally insist on decreased activity
after surgery and instruct the patient to keep the
head elevated when lying down, to use cold compresses
to reduce swelling, and to avoid any activity that
places undue stress on the area of the incision. Depending
on the surgery performed and the site of the scar,
the facial plastic surgeon will explain the types
of activities to avoid. No medication should be taken
without first consulting the surgeon. It is important
to remember that scar tissues require a year or more
to fully heal and achieve maximum improved appearance.
Facial plastic surgery makes it possible to correct
facial flaws that can undermine self-confidence. Changing
how your scar looks can help change how you feel about
Insurance does not generally cover surgery that is
purely for cosmetic reasons. Surgery to correct or
improve scars caused by injury may be reimbursable
in whole or in part. It is the patient's responsibility
to check with the insurance carrier for information
on the degree of coverage.
Copyright 2000 American Academy of Facial and Reconstructive