Scar Revision

Based in the heart of NY, Advance Foot and Ankle Solutions offers the best facility for performing scar revision, while catering to all other various foot and ankle problems. Look no further when you can have direct access to the globally acclaimed specialist team of foot and ankle surgeons, supervising & managing your scar revision with diligence and dedication.

Advance Foot and Ankle Solutions support team is absolutely attentive to your requirements related to scar revision. Call & book an appointment right away for professionally diagnosed, treated and empathetically cured foot and ankle issues, to lead a wholesome, enviable lifestyle.

Scar Defined & Explained By Your Doctor

By definition, a scar is a mark left on the skin or within body tissue and is the body’s natural way of healing and replacing lost or damaged skin as a result of a wound, burn, infection, surgery, inflammation of tissue or sore that has not healed completely, developing a fibrous, connective tissue. It should be borne in mind that scars cannot be completely removed by any known method.

Scarring is the process by which wounds are repaired naturally. Scar is a result of damage to the deeper layer of the skin, the dermis. Damage to only the most superficial layer of skin, the epidermis, would not always end up in a scar. Scars produce a structural change in the deeper layers of the skin which is manifested and perceived as an alteration in the architecture of the normal surface features, and is not merely a change in skin color. Only the fetal tissues and mucosal tissues possess the ability to heal without producing a scar behind.

Scar revision is a surgical procedure designed to:

  • Reduce Or Improve The Appearance of scars
  • Restore Function in the body part restricted by the scar
  • Correct Skin Changes (Deformations) caused by an injury, wound, poor healing, or formal surgical procedure

Factors Determining The Appearance Of Scars

Scars may appear anywhere on the body, and the composition of a scar is quite variable. These may be observed as:

  • Flat
  • Lumpy
  • Recessed
  • Colored
  • Painful
  • Itchy

The final look of a scar depends on many factors, including:

  • The Skin Type & Characteristics, such as color (pigmentation)
  • Location, Size & Depth of the wound on the body
  • The Direction of the wound
  • The Type of injury
  • Age of the affected person
  • Nutritional Status of the patient

The Signs & Indications Of Scars

  • A scar that is inclined at an angle to the normal feature lines of the skin
  • A scar that is thickened and hardened
  • A scar that causes aberration and deformation of other adjacent features
  • A scar that causes hindrance in normal movement or function
  • A keloid, which is an abnormal scar that is thicker, of a different color and texture than the rest of the skin, making it more prominent

The Diagnostic Procedure Of Scars

  • Visual Inspection is almost always the first step
  • Biopsy Of The Skin after the injection of a local anesthetic is carried out
  • Complication Of A Scar may result in other skin conditions within the scar that can be diagnosed via biopsy
  • Microscopic Examination Of The Scar Tissue is carried out after biopsy to ascertain its true nature

Considerations Prior To Surgical Approach

Prior to deciding on employing surgical approach for scar removal, your treatment specialist should be well aware of the wound healing stages and the exact process of scar formation. Wound healing occurs in 4 definite stages to end up with scar formation, discussed below:

  • The Inflammatory Phase that serves to ward off entry of infectious pathogens and foreign particles to prevent further deterioration
  • The Proliferative Phase that usually overlaps the 1st phase and leads to the development of collagen extracellular matrix via various micro-processes
  • The Granulation Phase that involves rapid growth of fibroblasts to strengthen the collagen extracellular matrix that acts as a platform for cells growth and deposition
  • The Remodeling Phase that is the longest duration of the healing process, featuring an orderly arrangement of collagen fibers to increase the fully healed wound’s tractile strength to 70%-80% of the pre-injury state

The Treatment Processes Of Scars

Since scars are an inevitable part of the normal healing process, ordinary scars are not considered to be treated. Only in the case of superficial scars that become aesthetically disagreeable or ones that produce a significant, unpleasant distortion of adjacent anatomical structures that they require elimination through treatment.

Scars generally shrink, become less noticeable and improve in appearance over the first year. So, you may be able to wait to consider invasive treatments prior to actually going for them until the scar lightens in color. This can be several months or even a year, after the wound has completely healed. On the other hand, complex scarring usually involves tissue contraction, making it unlikely that scars which pull or twist other surrounding anatomical structures, producing unpleasant results, would improve through noninvasive techniques. These extensive scars should be treated sooner enough.

The Conservative Treatment Methodology

The noninvasive remedies to reduce scarring mainly comprise of appropriate wound care to prevent extension in scarring and favor rapid healing process. The primary goal is to keep the wound moist and covered (after the wound has developed skin via epithelialization) in order to diminish the lumpiness and thickness of scars.

  • Gels & Antibiotic Ointments
  • Pressure Garments And Scar Massage
  • Botulinum Toxin Injections
  • Intralesional Injections
  • Contact Cryotherapy
  • Laser Therapy
  • Resurfacing
  • Soft-Tissue Augmentation

The Surgical Treatment Methodology

For longer-term, better results surgical treatment intervention presents as a more viable option. All invasive methods have varying degrees of success results. The surgical methods that are employed by the surgeons include the following:

  • Shave Excision
  • Fusiform Excision
  • Z-Plasty
  • M-Plasty
  • W-Plasty
  • Geometric Broken Line Closure

The Postoperative Care & Precautions

  • For Keloid Revision, a pressure or elastic dressing may be placed over the area
  • For Other Types Of Scar Revision, a light dressing is applied
  • Stitches Are Usually Removed after 3-4 days for the facial area, and 5-7 days for other incisions
  • The Type, Degree & Location Of The Surgery determine your resumption of normal activity and routine
  • Avoid Such Activities that may stretch and widen up the newly formed scar
  • Arrange For Physiotherapy for long-term joint stiffness after surgery
  • Apply Sunscreen & Sunblock Preparations to prevent permanent tanning the healing revision scar

The Complications & Risks Involved

The general complications related to surgery include the following:

  • Bacterial Infection In The Wound
  • Respiratory Problems
  • Excessive Bleeding From The Wound
  • Blood Clot Formation
  • A Bad Reaction To The Anesthesia

The complications related to scar revision surgery include the following:

  • Scar Recurrence
  • Keloid Formation (Or Recurrence)
  • Separation (Dehiscence) Of The Wound
  • Inadequate Or Traumatic Wound Closure
  • Excessive Use Of Electrocautery
  • Inappropriate Postoperative Wound Care
  • Injudicious & Excessive Debridement
  • Tense & Tight Wound Closure
  • Lack Of Wound Margin Eversion
  • Wounds Staying Dehydrated & Desiccated