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General Practice 2023

Surgery to remove scar: like é done, recoverção and who can do it

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Surgery to remove scar: like é done, recoverção and who can do it
Surgery to remove scar: like é done, recoverção and who can do it

Plastic surgery to correct a scar is intended to repair changes in the healing of a wound in any part of the body, due to a cut, burn or previous surgery, such as a cesarean section or appendectomy, for example.

The purpose of this surgery is to correct skin defects, such as irregularities in texture, size or color, providing a more uniform skin, and is only performed on more severe scars or when other types of aesthetic treatments do not work, such as use of silicone plates, radiotherapy or pulsed light, for example. Learn about scar treatment options before surgery.

How the surgery is performed

The procedure performed to remove the scar depends on the type, size, location and severity of the scar, and is chosen by the plastic surgeon according to the needs and healing tendency of each person, and may use techniques that use cuts, removal or reorientation of parts of the affected skin.

Types of surgery

  • Z-plasty: it is the most popular for scar revision;
  • Z-Plasty Half: when the adjacent skin on one side of the scar is elastic and on the other is not;
  • Four-flap Z-plasty (Limberg flap): it is particularly interesting for the release of severe scar contractures that tie or restrict normal flexion or in or in burns;
  • Planimetric Z-plasty: it is indicated for flat areas, and the triangle of the z-plasty is placed as a graft;
  • S-plasty: for the treatment of oval contracted scars;
  • W-plasty: to improve irregular linear scars;
  • Broken geometric lines: to randomly convert a long linear scar to an irregular scar to make it less visible;
  • V-Y and V-Y advancement: in cases of small contracted scars
  • Subcision and filling: For retracted and sunken scars that require filling with fat or hyaluronic acid;
  • Dermoabrasion: This is the oldest technique and can be done manually or with a machine.

To perform the surgical procedure, the doctor may request some preoperative blood tests. As in any surgery, fasting for 8 hours is recommended, and the type of anesthesia performed depends on the procedure to be performed, which can be local, with light or general sedation.

In some cases, a single procedure is enough to guarantee satisfactory results, however, in more complicated cases, repeating or performing new treatments may be recommended.

What is recovery like

After the surgery, swelling and redness of the site can be noticed, so the result of the procedure begins to be seen only after a few weeks, and complete healing can take months and even 1 year to be seen. to complete. In the recovery period, it is recommended:

  • Avoid intense physical activities;
  • Do not expose yourself excessively to the sun for 30 days;
  • Never forget to use sunscreen, even after complete healing;

In addition, to help with optimal healing after this surgery, preventing the scar from getting ugly again, the doctor may recommend doing other topical treatments such as applying silicone plates, applying healing ointments or using compressive dressings, for example.. Learn what are the main recommended care after any plastic surgery to facilitate recovery.

Who can have the surgery

Scar correction surgery is indicated by the plastic surgeon in situations of scar formation defects, which can be:

  1. Keloid, which is a hardened scar that grows larger than normal due to a large production of collagen, and may be itchy and red;
  2. Hypertrophic scar, which is also a thickened scar, due to disordered collagen fibers, which may be darker or lighter than the surrounding skin;
  3. Retracted scar or contracture, causes an approximation of the surrounding skin, very common in cesarean sections, abdominoplasty or due to a burn, making it difficult to move the skin and nearby joints;
  4. Enlarged scar, is a shallow and loose scar, with a lower surface than the skin;
  5. Dischromic scar, which causes a change in skin color, which can be lighter or darker than the surrounding skin;
  6. Atrophic scar, in which the scar is deeper than the relief of the surrounding skin, very common in wounds and acne scars.

The purpose of the surgery is to improve the appearance and standardize the skin, not always guaranteeing the complete erasure of the scar, and the results may vary according to the skin of each person.

Other scar treatment options

Other possible treatments, which are recommended as a first choice before undergoing surgery, are:

1. Aesthetic treatment

There are several techniques, such as chemical peeling, microdermabrasion, use of laser, radiofrequency, ultrasound or carboxytherapy, which are very useful to improve the appearance of lighter scars, such as pimples, or to even out skin color.

These treatments can be performed by the plastic surgeon or dermatologist in milder situations, however, in cases of larger and difficult-to-treat scars, they may not be effective, and other treatments or surgery should be chosen. See, in more detail, some of these aesthetic treatment options to improve the appearance of the scar.

2. Treatment with tapes and ointments

It is done with the placement of silicone plates, tapes or compressive dressings, indicated by the dermatologist or plastic surgeon, which can be used for weeks to months. Massages with special products can also be recommended, which help to reduce the thickening, fibrosis or change in the color of the scar.

3. Injectable treatment

To improve the appearance of depressed or atrophic scars, substances such as hyaluronic acid or polymethylmethacrylate can be injected under the scar, in order to fill the skin and make it smoother.The effect of this treatment can be more temporary or lasting, depending on the type of material used and the conditions of the scar.

In hypertrophic scars, steroid injections can be performed to reduce collagen formation, reducing the size and thickening of the scar.

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