Scar Revision Surgery

A scar is a mark left after a wound has healed. Scar revision surgery can help improve the look of a scar or make it less visible. If the scar is tight and restricts movement of the skin, revision can improve this. No scar can be completely erased. But scar revision surgery can help a scar look and feel better.

Types of surgery

Scar revision surgery can be done in a number of ways. The method used depends on the type of scar you have and where it is on your body. You and your doctor will discuss these details before the surgery. Common methods of scar revision surgery include:

  • Skin graft: Scar tissue is removed. It is then replaced with a piece of healthy skin (graft) taken from another part of the body. 

  • Z-plasty: A Z-shaped incision is made through the scar tissue and some healthy skin. (If the scar is very large, more than one incision may be made.) The Z-shape creates pointed skin flaps that can then be arranged for a more pleasing look and contour.

Preparing for surgery

Prepare for the surgery as you have been told. In addition:

  • Tell your doctor about all medications you take. This includes herbs and other supplements. It also includes any blood thinners, such as warfarin, clopidogrel, or daily aspirin. You may need to stop taking some or all of them before surgery.

  • Do not eat or drink during the 8 hours before your surgery, or as directed by your surgeon. This includes coffee, water, gum, and mints. (If you have been instructed to take medications, take them with a small sip of water.)

The day of surgery

The surgery takes 2 to 4 hours. You may go home the same day. Or you may stay 1 or more nights.

Before the surgery begins:

  • An IV line is put into a vein in your arm or hand. This line delivers fluids and medications.

  • You will be given medication (anesthesia) to keep you pain free during the surgery. You may receive sedation, which makes you relaxed and sleepy. Local anesthesia also used to numb the surgical area. In certain cases, general anesthesia is used instead. This puts you into a state like deep sleep during the surgery. With general anesthesia, a tube may be inserted into your throat to help you breathe. The anesthesiologist will discuss your options with you.

During the surgery:

  • Your doctor will repair the scar using the method discussed with you prior to the surgery.

  • You will be taken to a recovery room to wake up from the anesthesia. You may be sleepy and nauseated. If a breathing tube was used, your throat may be sore at first. You will be given medication to manage pain. If the revision is to a large area, you may stay one or more nights in the hospital. Once you are ready to go home, have an adult family member or friend drive you.

Recovering at home

Once at home, follow the instructions you have been given. Your doctor will tell you when you can return to your normal routine. To help your healing:

  • Take any prescribed medications exactly as directed.

  • If advised by your doctor, use a cold pack wrapped in a thin towel to relieve discomfort and control swelling. It’s important not to leave the cold pack on for too long, or your skin could be damaged. Put the pack over your bandages for no more than 10 minutes at a time. Then, leave it off for at least 20 minutes. Repeat this as often as needed during waking hours until swelling starts to improve. Don’t fall asleep with the cold pack on. If you’re not sure how to safely use the cold pack, ask your doctor.

  • Follow all instructions from your doctor for taking care of the incision. Leave the bandage in place until you are told to remove or change it. Once you can change your bandage, do so every 24 hours or as directed. Also replace the bandage whenever it gets wet or dirty. Wash your hands before changing the bandage.

  • Keep the surgical site clean and dry. You can get it wet after 48 hours. Rinse the surgical site gently and pat it dry.

  • Keep the surgical site out of the sun as it heals. This will help ensure a better outcome. At first, cover the healing skin with a bandage or clothing. When your doctor says it’s okay, you can use sunscreen on the site.

When to call the doctor

Call the doctor if you have any of the following:

  • Chest pain or trouble breathing (call 911 or other emergency service)

  • A fever of 100.4°F (38.0°C) or higher (or as directed by your doctor)

  • Symptoms of infection at an incision site, such as increased redness or swelling, warmth, worsening pain, or foul-smelling drainage

  • Bleeding or drainage from the incision

  • Pain that is not relieved by medication

Follow-up

You will have follow-up visits so your doctor can see how well you’re healing. During these visits, your doctor can monitor the results of your surgery. Let your doctor know if you have any questions or concerns.

Risks and complications

Risks and possible complications include:

  • Bleeding

  • Infection

  • Blood clots, which can travel to the lungs, heart, or brain

  • Damage to nerves, muscles, or blood vessels

  • Changes in skin sensitivity

  • Skin discoloration

  • Not liking look of revised scar

  • Recurrence of a keloid scar

  • Risks of anesthesia (the anesthesiologist will discuss these with you)



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