Scar tissue is a normal result of the healing process. Whenever the skin has been broken, whether by an injury, infections such as acne, or even surgery, there will always be a scar. Scars are permanent in nature and cannot be removed totally. The appearance of scars often can be improved so they are less unsightly, less noticeable and altogether more readily camouflaged with cosmetics. [Before and after a Scar Revision] WHAT IS SCAR REVISION?
This improvement in scar appearance is the goal of facial plastic surgeons when they perform "scar revision" procedures. Dr. Younger's success depends on many factors including the scar's size, shape, location and the patients age, heredity, and general skin condition. The three most common types of scars are:
Hypertrophic scar. An excessive amount of scar tissue in an incision or wound characterizes this type of scar. The scar itself appears redder in colour and firmer in texture than the surrounding skin, and rises above it.
Keloid scar. This type of scar exhibits the same characteristics as the hypertrophic scar, plus one more -- it continues to grow and enlarge with time. Areas most likely to develop keloid scars are the earlobes, chin, neck and shoulders.
Acne scar. The most common type of facial scarring comes from acne infections. THE COMMON SOLUTION?
Since scar revision procedures may affect patients differently, each scar and patient require careful assessment by Dr. Younger before he selects a procedure to improve the scar. The most frequently used procedures are:
Excision. Although scars cannot be totally eliminated, scar tissue can be removed and wound edges carefully sutured to create an even, narrow scar. Very wide scars or scars in areas of severe tension sometimes may be narrowed in stages. The term "excision" also includes surgical techniques whereby Dr. Younger repositions or irregularizes the scar so that the appearance may be more easily camouflaged.
Filler injections. Scars that lie in appropriate directions and are narrow, but are depressed, can be filled with restylane, fat, gortex or other filler substances. Some of these are not permanent and may need periodic augmentation.
Steroid injections. Some scars, particularly the hypertrophic and keloid scars, are improved by injection of steroid medication. This medication does not narrow the scar but often will flatten and soften it, achieving a blending with surrounding skin.
Dermabrasion. Some scars may be smoothed or "sanded" to blend with surrounding skin through dermabrasion.
Laser. Some scars may be smoothed very precisely with the skin resurfacing laser. In combination with topical skin agents, (vitamin A and glycolic acid) the laser will give a dramatic improvement. DECIDING ON THE OPERATION
Most scars will improve with time and should be allowed to mature and completely heal prior to initiating surgical treatment. Usually treatment will not be instituted until several months following a wound; sometimes a year or more is recommended. During your initial consultation visit, Dr. Younger makes a thorough evaluation of your facial features to determine whether surgery is indicated. He then will discuss any questions and concerns related to the surgery. In addition to the skill of the surgeon, your realistic expectations about the results of the surgery and general emotional state are important considerations. Mental attitude is as important as the ability to heal in evaluating candidates for facial plastic surgery. Once surgery is agreed upon pre-operative photographs are taken to help us plan the operation. These photographs usually are compared with similar ones taken sometime after surgery and serve as a permanent before-and-after record of the results. HOW MUCH DOES IT COST?
The cost of scar revision varies, depending on the extent and complexity of the scar. Our office will be able to give you an estimate prior to initiating therapy. The Medical Services Plan of BC may cover scar revisions, depending on how the scars were caused (i.e. disease, operative procedure or by an accident). Dr. Younger will consult with M.S.P. services in advance of the operation regarding coverage.
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