Scar Revision Surgery (Skin Grafting Surgery) - San Diego, CA

Scars - whether they're caused by accidents or by surgery - are unpredictable. The way a scar develops depends as much on how the body heals as it does on the original injury and on the surgeon's skills. Many variables can affect the severity of scarring, including the size and depth of the wound, the blood supply to the area, the thickness and color of the skin, and the direction of the scar. While no scar can be removed completely, Dr. Manish Champaneria can perform scar revision surgery to minimize and improve the original scar for patients in the San Diego area. Many scars that appear large and unattractive at first may become less noticeable with time. Some can be treated with steroids to relieve symptoms such as tenderness and itching. It is recommended that the patient wait as long as a year or more after an injury or surgery before deciding to have scar revision. Dr. Champaneria will examine the scar and discuss the possible methods of treating the scar, including the risks and benefits involved and the possible outcomes. Patients should be frank when discussing their expectations with the surgeon.

Keloid Scars
Keloids are thick, puckered, itchy clusters of scar tissue that grow beyond the edges of the wound or incision. They are often red or darker in color than the surrounding skin. Keloids occur when the body continues to produce the tough, fibrous protein known as collagen after a wound has healed.

Hypertrophic Scars
Hypertrophic scars are often confused with keloids, since both tend to be thick, red, and raised. Hypertrophic scars, however, remain within the boundaries of the original incision or wound. They often improve on their own, in a year or more, or with the help of steroid applications or injections.

Contractures
Burns or other injuries resulting in the loss of a large area of skin may form a scar that pulls the edges of the skin together, a process called contraction. The resulting contracture may affect the adjacent muscles and tendons, restricting normal movement.

There are various techniques to consider during a revision surgery. Scar revision treatment will be chosen based on the scar’s location, type, size and overall extent and may include one of the following approaches. 

Z-plasty is a surgical technique used to reposition a scar so that it more closely conforms to the natural lines and creases of the skin, where it will be less noticeable. It can also relieve the tension caused by contracture. Not all scars lend themselves to Z-plasty, however, and it requires an experienced plastic surgeon to make such judgments.

Skin grafts and flaps are more serious than other forms of scar surgery. They're more likely to be performed in a hospital as inpatient procedures, using general anesthesia. The treated area may take several weeks or months to heal, and a support garment or bandage may be necessary for up to a year.

Scar treatment is usually performed using a local anesthesia. In cases where a large area is going to be treated, a general anesthesia may be needed. Post-surgery care is critical when it comes to scar treatments. Patients must adhere to the medications and proper wound care to promote better healing of the new wound resulting in a less visible scar. Although a scar will still exist on the site, patients note a significant improvement. It usually takes between 6 months and longer for optimal results.