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Scar Revision Surgery

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Scars are visible signs that remain after a wound has healed. They are unavoidable results of injury or surgery, and their development can be unpredictable. Poor healing may contribute to scars that are obvious, unsightly or disfiguring. Even a wound that heals well can result in a scar that affects your appearance. Scars may be raised or recessed, different in color or texture from surrounding healthy tissue or particularly noticeable due to their size, shape or location.

At Laser Skin Care, your treatment options may vary based on the type and degree of scarring and can include:

  • Simple topical treatments
  • Minimally invasive procedures
  • Surgical revision with advanced techniques in wound closure

Scar revision surgery is meant to minimize the scar so that it is more consistent with your surrounding skin tone and texture.  Although scar revision can provide a more pleasing cosmetic result or improve a scar that has healed poorly, a scar cannot be completely erased.

Different Types of Scars

  • scar_1 Discoloration, surface irregularities: Subtle scarring which can be cosmetically improved by surgery or other treatments. These types of scars do not impair function or cause physical discomfort and include acne scars as well as scars resulting from minor injury and prior surgical incisions.
 

 

 

 

  • scar_hypertropic Hypertropic scars are thick clusters of scar tissue that develop directly at a wound site. They are often raised, red and/or uncomfortable, and they may become wider over time. They can be hyperpigmented (darker in color) or hypopigmented (lighter in color).

 

 

 


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  • Keloids are larger scars which extend beyond the edges of an original wound or incision and may be painful, itchy, or puckered. Keloids can occur anywhere but they are more common where there is little underlying fatty tissue, such as on the face, neck, ears, chest or shoulders.

 

 

 


  • scar_contracture Contractures are scars that restrict movement due to skin and underlying tissue that pull together during healing. They can occur when there is a large amount of tissue loss, such as after a burn. Contractures also can form where a wound crosses a joint, restricting movement of the fingers, elbows, knees or neck. Contractures can be small, but generally involve more surface and underlying tisse, often necessitating more extensive and invasive techniques for revising the affected area to a more functional and cosmetically pleasing result.

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Treatment Choices

Charles H. Hutchins, MD has over three decades of medical and surgical experience. He operates in both the hospital operating room and his office operating rooms in uptown Charlotte and Gastonia, NC. Dr. Hutchins is "triple-boarded" with certification by the following:

  • Diplomate: American Board of Facial Plastic and Reconstructive Surgery
  • American Board of Otolaryngology -- Head and Neck Surgery
  • American Board of Otolaryngologic Allergy

The degree of improvement that can be achieved with scar revision will depend on the severity of your scarring, and the type, size and location of the scar. In some cases, a single technique may provide significant improvement. However, a combination of scar revision techniques will usually be used to achieve the best results.  

Topical treatments, such as gels, tapes or external compression, can help in wound closure and healing, or to reduce the ability of skin to produce irregular pigment. These products may be used to treat existing surface scars and discoloration, and to aid in healing of scar revision procedures.

Injectable treatments are often used to fill depressed or concave scars. Depending on the injectable substance used and your particular scar conditions, results may last from three months to several years. Therapy must be repeated to maintain results. One form of injection therapy uses steroidal-based compounds to reduce collagen formation and can alter the appearance, size and texture of raised scar tissue.

Surface treatments are most often used for cosmetic improvement of scars. These methods can soften surface irregularities and reduce uneven pigmentation. Surface treatments are a controlled means of either mechanically removing the top layers of skin or changing the nature of tissue. These treatment options include:

  • Dermabrasion is a mechanical polishing of the skin.
  • Laser or light therapy causes changes to the surface of the skin that allow new, healthy skin to form at the scar site.
  • Chemical peel solutions penetrate the skin’s surface to soften irregularities in texture and color.
  • Skin bleaching agents are medications applied topically to lighten the skin.

Sometimes for deeper scars an incision is needed to surgically remove the old scar and require layered closure. Dr. Hutchins is a published author of specialized suturing techniques to minimize scarring. Layered closure is often used where excision extends to tissue below the skin surface or in areas with a high degree of movement. Advanced techniques in scar revision include complex flap closure to reposition a scar so that it is less conspicuous, or improve flexibility where contracture has restricted mobility.

Pharmaceutical tissue substitutes may be used if ample healthy tissue is not present for closure of a scar excision. This is more likely with revision of severe burn scars.

Tissue expansion can be a substitute for skin grafts. In this procedure, an inflatable balloon called a tissue expander is placed under the skin near the scar site. Over time, the balloon is slowly filled with sterile solution to expand the area of healthy skin. Once the skin has been stretched sufficiently, the expander and the scar is removed and the stretched skin is moved to replace the scar tissue. This process can involve multiple surgical stages or procedures in order to achieve the final results.

If you have an unsightly scar that affects your appearance or self esteem you should have it evaluated. At Laser Skin Care, we are commited to your health, well being, and suport your dicision to improve your appearance where possible. A consultation with Dr. Hutchisn is free. You can walk away with realistic expectations and make a decision about whether scar revision surgery may be right for you.


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~ Free consultation and skin cancer screening ~
750 Cox Road, Gastonia, NC 28054
(704) 867-7212

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