Scar Revision Portland

Scarring is affected by the blood supply to the injured area, the color of your skin, the depth of the wound, the direction of the scar, the size of the wound and the thickness of your skin. With a scar revision in Portland, Dr. Bartholomew can improve the appearance of your scar.

It is recommended that you wait at least a year after an injury or surgery before considering a scar revision.

Who is a Candidate for a Scar Revision?

Any men and women in good physical health can be a good candidate for scar revision.

This thick, over-grown cluster of scar tissue on the earlobe is a keloid. Here it has been removed and the incision closed with stitches, leaving a thin scar.

This hypertrophic scar has formed a contracture, restricting finger motion.

What are the Risks?

Scar revision is a safe procedure but there are minor risks of a bad reaction to anesthesia, bleeding, infection or recurrence of an unsightly scar.

Using Z-plasty, the scar is removed and several incisions are made on each side, creating small triangular flaps of skin. Then the flaps are rearranged and interlocked to cover the affected area.

Initial Consultation

During your initial consultation, you will have the opportunity to ask Dr. Bartholomew, a board-certified plastic surgeon, your questions and concerns about scar revision. How should you scar be treated? What are the benefits of this procedure? What are the possible outcomes? You will be able to discuss your goals with Dr. Bartholomew, who will make a recommendation during your consultation.

The incision is closed with a Z-shaped line of sutures. The new scar is thinner and less visible, and allows the finger to be extended.

Scar Revision Procedures

Keloid Scar

A thick clusters of red or dark in color scar tissue growing beyond the edges of the incision. Keloid scars are what happened after a wound has healed but the body still produces collagen. They usually show up over the breastbone or on the earlobes or shoulders. By injecting a steroid medication into the scar tissue, the redness and burning sensation can be reduced in keloid scars. It may even shrink it too. Another approach is to cut out the scar tissue and close the wound with stitches.

Keloid scars are known to be stubborn and recurring which is why some surgeons will combine the scar removal with steroid injections or direct usage of steroids during surgery to stop this from happening. There is always a risk a keloid scar might return and require further procedures.

Hypertrophic Scar

Similar to keloid scars in thickness and color (redness). The difference is that hypertrophic scars stay within the area of the wound or incision. Some of those scars improve on their own or with the aid of steroid injections. These scars can also be dealt with surgically by removing the excess scar tissue. Additional steroid injections can be given for up to two years to prevent the scar from reforming.

Contracture

A process resulting from burns or other injuries in an area of skin that forms a scar, which pulls the edges of the skin together. It ends up affecting the muscles and tendons in the area and restricting normal movement. To rectify the problem, the scar is usually cut out and replaced with a skin graft or a flap.

Facial Scar

Usually considered a cosmetic issue but an experienced surgeon like Dr. Bartholomew can make it less noticeable by cutting and closing the scar with tiny stitches. He may use the Z-plasty procedure to reposition the scar and make it run parallel to the natural skin creases.

Dermabrasion

A technique used to soften facial scars and give a smoother surface to the skin. This technique scraps the top layers of the skin with the use of a hand-held, high-speed rotary wheel.

Z-plasty

A surgical technique used to change a scar so that it conforms to the natural lines and creases of the skin making the scar less noticeable, a “Z” pattern. It can also relieve tension caused by contracture. Z-plasty removes the old scar and creates new incisions on each side of small triangular flaps of skin. The flaps are reorganized to cover the wound at a different angle. Performed as an outpatient procedure, Z-plasty uses fine stitches to close the wound and make the scars as inconspicuous as possible.

Skin Grafting

Transfering your skin from a donor site, a healthy part of the body, to the recipient site. The skin then meshes with the blood vessels and scar tissue. It is better to use a person’s own skin to deal with a scar. Occasionally, the grafts do not bond properly. There can be scarring at the donor and recipient sites.

Flap Surgery

The most complex scar procedure moving skin with its underlying fat, blood vessels and muscles from a healthy part of the body to a recipient site. The blood vessel can either remain attached at one end to the donor site or reattached at the recipient site (via microvascular surgery).

The scar crossing the natural line, or crease, between the nose and mouth is removed and repositioned using Z-plasty. The forehead scar, located in the natural lines, is excised with tapered ends. The skin is then loosened and brought together with stitches.

The repaired scars now lie partly within the natural skin crease, where they are less visible.

Recovery

You should expect to feel some pain after your surgery, depending on what type of procedure you undergo. Dr. Bartholomew can prescribe medication for your discomfort.

You’ll need to follow the instructions that will be given to you to ensure that your wound heals properly. Moving around will be acceptable but you will not be able to resume your normal activities for a few days.

It is perfectly normal for your scar to actually look worse after your surgery. It can take more than a year before you see the final results. How your scar improves will depend on its size and direction, how well you take care of it and the nature of your skin.

Getting a scar revision in Portland will improve your scar and its appearance.

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