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Scar Revision in Birmingham AL

Minimize Scars Anywhere on the Body

Scars are visible signs that remain after a wound has healed. They are the 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 noticeable due to their size, shape or location. They can also be raised or depressed, and may differ in color or texture from the surrounding healthy tissue.

Scar Revision is plastic surgery performed to improve the condition or appearance of a scar anywhere on your body. Scar revision surgery is meant to minimize a scar so that it is less conspicuous and blends in with the surrounding skin tone and texture.

Treatment options at our Birmingham, Alabama plastic surgery center vary based on the type and degree of scarring. They can include simple topical treatments, minimally-invasive procedures and surgical revision with advanced techniques in wound closure.

Scar Revision Candidates

Scar revision can be performed on people of any age and is a good option for you if:

Types of Scars

The type of scar you have will determine the appropriate technique(s) your plastic surgeon will use to improve your scar.

Face with discoloration, surface irregularities
Subtle scars
Face with hypertropic scar
Hypertropic scars
Ear with keloid scar
Keloid scars
Arm with contracture scar
Contracture scars

Discoloration and Surface Irregularities

Discoloration, surface irregularities and other more subtle scars can be cosmetically improved by surgery or other treatments recommended by your plastic surgeon. These types of scars do not impair function or cause physical discomfort. They include acne scars as well as scars resulting from minor injury and prior surgical incisions.

Hypertropic Scars

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

Keloid Scars

Keloids are larger than hypertropic scars. They can be painful or itchy and may also pucker. They extend beyond the edges of an original wound or incision. Keloids can occur anywhere on your body, but develop more commonly where there is little underlying fatty tissue, such as on the face, neck, ears, chest or shoulders.

Contracture Scars

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 can also form where a wound crosses a joint, restricting movement of the fingers, elbows, knees or neck.

Your Scar Revision Consultation

The success and safety of your scar revision procedure depends very much on your complete candidness during your consultation. You will be asked a number of questions about your health, desires and lifestyle. Be prepared to discuss:

Your scar revision surgeon may also:

Scar Revision Risks and Safety

Each patient must decide if the benefits of scar revision surgery will achieve their goals, and if the risks and potential complications are acceptable. The risks of scar revision include:

Your plastic surgeon and/or staff will explain in detail the risks associated with scar revision. You will be asked to sign consent forms to ensure that you fully understand your scar revision procedure, the alternatives and the most likely risks and potential complications.

Preparing for Scar Revision

Prior to scar revision surgery, you may be asked to:

Special instructions you receive will cover:

Scar revision surgery is performed at our accredited Outpatient Surgery Facility in Birmingham, Alabama where your plastic surgeon and our staff will fully attend to your comfort and safety.

Scar Revision Procedures

The severity of your scarring — along with the type, size and location of the scar — will determine the appropriate scar revision technique(s) and the degree of improvement that can be expected. In some cases a single technique may provide significant improvement. However, your plastic surgeon may recommend a combination of scar revision techniques to achieve the best results.

Anesthesia choices for scar revision include local anesthesia, intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you.

Topical Treatments

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 aid in the healing of other scar revision procedures.

Injectable Treatments

Dermal fillers are an effective option to fill depressed or concave scars. Depending on the injectable substance used and the particular conditions of your scar, results may last from 3 months to several years. Since volume-enhancing results with dermal fillers are temporary, therapy must be repeated to maintain the best results.

Another form of injection therapy uses steroidal-based compounds to reduce collagen formation and alter the appearance, size and texture of raised scar tissue.

Scar revision with injectable treatments before and after
Scar revision with injectables

Surface Treatments

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

  • Dermabrasion mechanically polishes the skin.
  • Laser or light therapy causes changes to the skin's surface that allow new, healthy skin to form at the scar site.
  • Chemical peels soften irregularities in texture and color by penetrating the skin's surface.
  • Skin bleaching agents lighten the skin with medications applied topically.
Scar revision with surface treatments before and after
Scar revision with surface treatments

Surgery for Deeper Scars

For deeper scars, an incision is sometimes needed to surgically remove the old scar.

Surgical scar revision before and after
Surgical scar revision

Layered CLosure

Some scars require layered closure, often used where excision extends to tissue below the skin's surface or in areas with a high degree of movement. First, closure below the skin's surface is performed with absorbable or non-removable sutures. Layers of closure continue to build, concluding with closure of the remaining surface wound.

Flap Closure

Advanced techniques in scar revision include complex flap closures and W-plasty or Z-plasty techniques. Flap closures may reposition a scar so that it is less conspicuous or improve flexibility where contracture has restricted mobility.

Tissue Substitutes

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

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 sufficiently stretched, 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.

Scar Revision Recovery

Following your physician's postoperative instructions is key to the success of your surgery. You will be given specific instructions that may include:

Seek medical attention immediately if you experience shortness of breath, chest pains or unusual heartbeats after going home. You may require hospitalization and additional treatment if any of these complications occur.

When your procedure is finished, bandages or dressings may be applied to keep the surgical site clean.

It's important that the surgical incisions are not subjected to excessive force, abrasion or motion during the time of healing.

The initial healing phase of a surgical scar revision may include localized swelling, discoloration or discomfort and may take 1 to 2 weeks. Healing will continue for several weeks and as the new scar heals it will slowly refine and fade. With dermabrasion, chemical peel or laser resurfacing, you will experience similar conditions at the treated area in addition to overall sensitivity.

Scar Revision Results

The final results of your scar revision surgery will be long-lasting. However, it may take several months for your final results to become apparent. In some cases it may take a year for the new scar to fully heal and fade.

Although scar revision can provide a more pleasing cosmetic result or improve a scar that has healed poorly, a scar cannot be completely erased.

Although good results are expected with your scar revision, there are no guarantees. In some situations it may not be possible to achieve optimal results with a single surgical procedure and another surgery may be necessary.

Scar Revision Words to Know

Procedure Information © American Society of Plastic Surgeons

Hedden and Gunn Plastic Surgery

Scar Revision minimizes the appearance of scars to make them more consistent with the surrounding skin.

Birmingham, AL Office & Surgery Suites

Hedden & Gunn Plastic Surgery
140 Village Street
Birmingham, AL 35242
205-980-1744 or 800-HeddenMD
American Society of Plastic Surgeons* American Society for Aesthetic Plastic Surgery*
* Dr. William Hedden, Dr. Stephen Gunn
Hedden and Gunn Plastic Surgery

Contact Us Today

Questions About Skin Procedures?

To learn more about Scar Revision procedures at Hedden & Gunn Plastic Surgery, please contact our Birmingham, AL practice today.

To schedule your consultation at the earliest possible date, please call 205-980-1744.

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