By Dr. Janjua (Janjua Facial Surgery)
You might have heard about scar removal, but the truth is that scars are permanent. They cannot be removed entirely. When doctors talk about scar revision or removal, they aim to make the scar less noticeable. My goal as a surgeon is to minimize your scar to the point where it’s barely visible unless pointed out. A fine line-like scar is often the best outcome.
Understanding Scars
Scars form as part of the body’s natural healing process after an injury. However, scars can sometimes heal in ways that make them more noticeable. This can be due to the texture or color of the scar. For example, scars can become darker, especially in individuals with darker skin tones. This is a condition known as post-inflammatory hyperpigmentation. Any skin injury that causes inflammation, including surgery, can result in a darker scar. Additionally, the texture of a scar can vary, appearing raised, depressed, or wide.
Common Causes and Types of Scars
Scars can form for various reasons, such as:
• Injuries (like cuts and lacerations)
• Burns
• Surgical procedures
• Repeated irritation
• Acne
• Infections
• Cancerous growths
• Intentional markings, such as tribal marks in some cultures
Scars can be described in several ways, such as:
• Depressed scars: These are lower than the surrounding skin.
• Hypertrophic scars: These are raised above the surrounding skin.
• Keloids: These are the most severe, growing beyond the original injury site and often causing pain and itching. They are more common in Asians and African Americans but are less likely to occur in areas like the midline of the face.
Color Changes in Scars
Scars may change color:
• Pale scars: These contrast with the surrounding skin by being lighter.
• Dark scars: These contrast by being darker.
• Red scars: Initially, scars can appear reddish due to increased blood supply during healing. Over time, they may blend into the surrounding skin but can sometimes remain lighter or darker.
Scar Revision Techniques
Scar revision is highly sought after, especially for facial scars. Treatments can be either surgical or non-surgical.
Non-Surgical Methods
• Laser treatments
• Microdermabrasion
• Microneedling
• Tattooing
• Makeup
• Filler injections which can elevate depressed scars
Surgical Methods
Surgical scar revision involves removing the old scar and creating a new, well-controlled scar. This procedure is typically performed by plastic surgeons. The key is to precisely approximate the skin edges and prevent tension that might widen the scar. Specialized techniques, such as W-plasty, Z-plasty, and geometric broken line closure, can also be used to make the scar less noticeable. You can find examples of these techniques on my YouTube channel @janjuafacialsurgery.
