Scar correction

The appearance of a scar after an operation depends on many factors. The most important of these are as follows: the character of the trauma causing the wound and subsequent scarring, the method of treatment, or complications in healing, location of the scar on the body, the direction of the scar with a view to the skin split lines, age of the patient at the time of the accident or operation, care for the scar at the time of its maturation and others. There are many ways in which it is possible to influence the appearance of a scar.

What do we try to improve about the scar?

As already mentioned, it is never possible to remove a scar completely. The efforts of the doctor and the patient thus remain efforts to ensure that it is as inconspicuous as possible. In most cases, a scar cannot be shortened. It is sometimes possible to make it narrower. Treatment is also focused on procedures which help to level the scar to the level of the skin if it is raised or if it dips into the skin. Sometimes it is advisable to change the direction of a scar or to move it to a less conspicuous place. We also try to treat the scar so that it is soft, painless and so that it does not itch. Last but not least, the objective is to influence its colour so that it differs from the colour of the surrounding skin as little as possible.

What are the treatment possibilities?

If the scar is fresh, it is advisable to lubricate it and perform pressure massage. This care can be supplemented with application of silicone patches or application of a laser biostimulation or use of a biolamp. Once the scar has matured (this mostly takes several months to a year) no effect can be expected from a conservative approach. If the scar protrudes above the level of the skin, it is possible to inject medicines containing corticoids directly into the scar. Another possibility is use of a surgical laser or cryotherapy. Open or sunken scars can be corrected satisfactorily by means of excision and tissue grafting or their filling in such a way that they are on the same level as the healthy surrounding skin. In the case of scars which are functionally limiting or inconveniently located with regards to the skin split line, it may be advisable to surgically change their direction and course. It is sometimes possible to surgically move a scar to a position where it is less conspicuous. In the case of keloid scars, which are difficult to manage, the scope of which exceeds the scope of the original trauma, a surgical technique is sometimes used with removal of their core. In the case of scars subject to long-term hyperaemia, it is possible to try for improvement by application of vascular lasers, which decrease the blood flow to them and thus help to speed up their fading. If it is not possible to perform permanent correction of a scar, it is also possible to consider camouflage, for example with a tattoo.

Essential pre-operative examination

If a procedure is planned under local anaesthetic, pre-operative examination is mostly not possible. If however an operation is to be performed under general anaesthesia, pre-operative examination is essential. It is however always necessary to inform the doctor of all medicines which the patient uses. This especially relates to medicines which affect coagulation.

Post-operative care

Post-operative care is governed by the scope and nature of the procedure performed and its location.

Complications

Complications are usually relatively rare after correction of smaller scars. In the case of larger-scale corrections, opening of the operative wound, creation of hematoma or infection and atrophic scarring come into consideration. The most frequent complication is recurrence of an unsatisfactory scarring process.