Scar formation is an inevitable consequence of wound healing from either a traumatic or a surgical intervention. The aesthetic appearance of a scar is the most important criteria to judge the surgical outcome. An understanding of the anatomy and wound healing along with experience, meticulous planning and technique can reduce complications and improve the surgical outcome. Scar revision does not erase a scar but helps to make it less noticeable and more acceptable. Both surgical and non-surgical techniques, used either alone or in combination can be used for revising a scar. In planning a scar revision surgeon should decide on when to act and the type of technique to use for scar revision to get an aesthetically pleasing outcome. This review article provides overview of methods applied for facial scar revision. This predominantly covers surgical methods.
A scar can be defined as a fault or blemish resulting from some former condition, wound, sore or burn. Scar formation is an inevitable consequence of wound healing in which the normal skin is replaced by a fibrous tissue. This scar tissue lacks the characteristics of the normal uninjured skin. A scar is classified into mature scar, immature scar, linear hypertrophic scar, widespread hypertrophic scar, minor keloid and major keloid. This review covers management issues related to only scars and not keloids.
There are a large number of tools available for scar assessment. The most important features which should be assessed are: colour, vascularity, light reflection, texture, contour, pliability, height, distortion, relation to the relaxed skin tension lines (RSTL), the natural skin lines and creases of the face and neck, which are the preferred lines of incision in surgery of those areas and relation with important landmarks in the area of the body.
The characteristics of an ideal scar which makes it cosmetically favourable are:
The various factors which should be considered before doing scar revision are:
There are non-surgical techniques for scar management.
A fundamental principle of surgical scar revision is to minimize as much as possible both incorporation and deformation of the normal tissue.
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