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Staged excision
Indications
This method is especially useful in cases where the size and density of the scar and surrounding skin make it impossible to excise and close the wound without damaging adjacent tissue.Execution technique
The usual scar excision is carried out, but in parts. In this case, each time a subcutaneous dissection of the soft tissue is performed and the skin is moved to close the resulting wound. How many of these excisions are needed depends on the size and location of the scar, as well as the elasticity of the surrounding skin. If there are more than two, then it may be worth using the skin extension method. This will reduce the number of interventions.Scar reorientation
Scar reorientation is especially effective for long scars that cross cosmetic areas or distort the appearance of tissue, as well as for webbed scars and long and prominent linear scars.Z-plasty
Z-plasty reduces contraction in scar areas by moving triangular flaps of skin, which allows you to change the direction of the scar, placing it along natural lines.Indications
Z-plasty is used in different situations. It allows you to lengthen a tightened scar, return anatomical landmarks on the face to their places, disguise scars with hair, reduce long linear scars, eliminate membranes and irregularities (however, there are more effective methods scar correction).Execution technique
Mark two lines on the skin, parallel to the natural lines on the body and at an angle of 60° to the original scar. These lines show the locations of future incisions and should be equal to or slightly longer than the scar (the length depends on the elasticity of the skin). The shape of the pattern on the skin will be similar to the letter “Z”. After excision of the scar and incisions along the marked lines, triangular flaps of skin are formed. They are moved in such a way as to create a new letter “Z”, located differently than the original one (Fig. 3.6).
Rice. 3.6. Z-plasty (scheme). Two additional incisions are made, equal in length to the scar and parallel to the natural lines. They are necessary to create skin flaps that are moved to form a new scar: A - the scar (a-b) is located across the natural lines; B - the scar is excised, two skin flaps are created, the edges of which are parallel to the natural lines. A 60° angle between the scar and each of the additional incisions results in a 75% lengthening of the scar; C - movement of skin flaps; D - new scar (b-a) located along natural lines
The new scar will be parallel to the natural lines, but will lengthen by 75%. The location of the center line in the letter "Z" can be visualized by mentally connecting the free ends of the original letter "Z". How much longer the new scar will be compared to the original depends on the angle between the arms of the original "Z" and the original scar. General rule: for every 15° increase in angle, the new scar lengthens by 25% (Table 3.3).
Table 3.3. Scar lengthening with Z-plasty 
By performing Z-plasty several times on small areas of the scar, it is possible to reduce skin tension and create several new scars located along natural lines (Fig. 3.7). To increase the mobility of the skin flaps, a subcutaneous incision is made around the scar. soft fabrics. The ends of the flaps should not be taut, otherwise necrosis may occur.
Rice. 3.7. Z-plasty is performed several times on small areas of a long scar (diagram): A - the scar is located across the natural lines; B - creation and movement of several pairs of skin flaps (a-b, c-d, e-f); C - new scars b-a, d-c, f-e (marked in red) are located along natural lines
Contraindications
Z-plasty cannot be used for keloid scars, because in case of relapse, the new keloid scar will be 3 times longer and will look even worse than the original one.Choi J., Rohrer T., Kaminer M., Batra R.
All materials on the site were prepared by specialists in the field of surgery, anatomy and specialized disciplines.
All recommendations are indicative in nature and are not applicable without consulting a doctor.
Author: , candidate of medical sciences, pathologist, teacher of the department pathological anatomy and pathological physiology, for Operation.Info ©
Scar excision is a method of surgically removing scar tissue, followed by carefully joining the edges of the wound and applying a cosmetic suture. The operation is indicated for ordinary scars, keloids of any localization, deforming, constricting, disfiguring scars of the face and other parts of the body.
The problem of having rough, unaesthetic, constricting scars that create not only physical, but also serious psychological discomfort is familiar to many. It is especially acute when scars are localized on open areas of the body, the face, where it is not always possible to hide them with clothing. Elimination of such defects can significantly improve the quality of life, give self-confidence and relieve psychological problems.
Scars that are large in area or are too long cannot always be completely excised. however, plastic surgeons can make them much less noticeable. IN difficult cases eliminating the defect may require several operations, as well as the parallel use of conservative techniques, peelings, dermabrasion, etc., which together will give, if not the desired, then close to it result.
Scar formation is a process reflecting reparative regeneration. Where it is not enough to simply increase the cell mass, the tissues are juxtaposed due to connective tissue fibers, which become denser and turn into a scar. The scar is considered to be fully formed approximately one year after the injury. it is quite strong, but in terms of stretchability and elasticity it is inferior to healthy skin, so it can tighten it, cause itching and deformation.
The healing process through scarring is considered favorable in terms of aesthetics if the scar is located flush with the surrounding skin, has a soft consistency and a pink color, which makes it less noticeable. Neat scars form after cuts, when the edges of the resulting wound are smooth and well aligned. In addition, the location of the scar relative to the natural lines matters: if it runs parallel to them, it will be less noticeable to others.
Indications and contraindications for surgical treatment of scars
The method that a plastic surgeon chooses to excise scars depends on the structure of the scars, their size and location. Surgical treatment subject to:
- Postoperative scars, which create a cosmetic defect due to discrepancy with natural lines, skin deformation, poor tissue suturing technique, inadequate comparison of skin edges during a previous operation. Most often they are located on the abdomen after abdominal interventions; in women, scars may be noticeable after caesarean section, especially if the cut was vertical;
- Scars that appear during pathological regeneration - keloids, hypertrophic. The reason for their appearance is an inadequate regenerative process against the background of infection, necrotic processes, exposure to foreign objects into the wound, too much tension on the sutures when treating wounds;
- Post-inflammatory atrophic scars due to previous skin diseases(acne, rosacea, chickenpox) - sunken, surrounded by thin skin;
- Scars due to injury- an unfavorable type, formed after wounds and burns, often massive, tightening the skin and disfiguring.
keloid scar
Keloid scars - frequent companion postoperative and post-traumatic healing, which is based on the impregnation of connective tissue with plasma proteins with the formation of a complex glycoprotein resembling cartilage tissue (hyalinosis). The danger of keloids is the possibility of their spreading beyond the original scar and recurrence. It takes about 2.5 years for such a scar to form. Keloids rise above the skin, are dense, pink-red in color, and often cause pain and severe itching.
Hypertrophic scars also protrude above the surface of the skin, but they are located strictly in the projection of the primary damage. It takes only a few weeks to form; hypertrophic growths are often localized in areas with mobile skin. This type of scarring responds quite well to both conservative and radical treatment, and in some cases even independent regression of the scar is possible.
Theoretically, absolutely any scar can be subjected to surgical excision, but the result of the operation may differ from the patient's expectations. Practice shows that only those who understand that it is unlikely to be able to completely get rid of a noticeable scar are satisfied with the cosmetic effect, because the purpose of excision of scars in difficult cases is not to completely remove them, but to make them less noticeable.
Before choosing a method of scar excision, the surgeon very carefully questions the patient about the nature of past operations, the presence of endocrine-metabolic pathology, and unfavorable heredity. Age is also important, since keloids are more likely to form in young people under 30 years of age.
Finally, the appearance of the scar itself puts the final point in choosing tactics. All characteristics are important, from the color, density, area and location of the scar to the condition of the surrounding tissues and the nature of the previous treatment.
Contraindications to scar excision surgically serve:
- Severe hemostasis disorders (laser is a possible alternative to a scalpel);
- Decompensated diseases internal organs;
- Mental illnesses;
- Inflammatory changes at the site of the intended excision;
- Age under 16 years (relative contraindication).
Preparation and principles of surgical treatment of scars
Preparation for scar excision surgery is similar to that for any other surgical intervention. The patient will need to undergo blood and urine tests, undergo fluorography, ECG, be examined for HIV, hepatitis, syphilis, and have a coagulogram.
After passing the examinations, examinations by a plastic surgeon and an anesthesiologist are scheduled. At least 2 weeks before surgery, stop taking blood thinners and non-steroidal anti-inflammatory drugs, and cancel any dietary supplements with ascorbic acid and vitamin E. Alcohol and, especially, smoking, which impairs regeneration and microcirculation, are contraindicated.
Patients at risk are prescribed antibiotic therapy for prophylactic purposes (for interventions in the armpit, perineum, after undergoing joint replacement, heart valve replacement in the next 2 years, after taking immunosuppressants and cytostatics).
Plastic surgeons have developed some general principles scar excision operations:
- Preliminary marking of both incision lines and anatomical landmarks with the patient standing or sitting, before the administration of local anesthetics;
- Preference is given local anesthesia, and in the case of a pronounced network of blood vessels, adrenaline is added to the anesthetic, which has a vasoconstrictor effect;
- After marking and anesthesia, the surgical field must be treated with antiseptics;
- Careful comparison of the incision lines, no tightening of the sutures, the use of inert and self-absorbing threads, the application of vertical mattress and support sutures are the key to speedy regeneration;
- The use of fewer stitches to prevent an inflammatory response; they are left on the face for 7 days, on the body - up to 2 weeks.
Developed for surgical excision of scar tissue several types of operating equipment:
- Tangential;
- Fusiform;
- Step-by-step methodology.
The choice of a specific type of scar excision is determined by the size, consistency, localization of the scar, its relationship with other parts of the body, the condition of the surrounding tissues, and the nature of the previous treatment. Big problem are complex cicatricial adhesions after a necrotic process, due to lacerations, removal of a large area of skin in the past, since the ability of the skin to stretch in these cases is greatly reduced. Surgical correction is carried out in close proximity to the scar, but does not touch it itself.
Tangential excision method useful in the presence of single narrow scar changes that have raised or uneven edges above the skin. During the operation of tangential removal of scar tissue, the latter is cut off with a scalpel or blade, as if compared with the level of the surrounding tissue. When cutting tangentially, it is important not to damage the underlying dermis.
Spindle removal (elliptical) It is carried out for a wide variety of scars - from very small to quite large, as well as wide, rising above the skin or sinking. After removal, thin scars remain in their place, coinciding with the direction of natural lines and folds and therefore invisible.
The goal of the spindle-shaped technique is the total removal of scar changes, regardless of width and thickness. The incision is made spindle-shaped at an angle of about 30 degrees, while the underlying tissue is also dissected to ensure that the edges are aligned without tension on the skin and subcutaneous layer. The method is used for post-traumatic, postoperative scars, scars after cesarean section.
The spindle-shaped technique can be used when the scar penetrates deeply into the dermis, while additional sutures are required to securely connect the tissues - deep self-absorbing interrupted, mattress in the dermis, running vertically, then nodal or cosmetic, which does not leave its signs after skin regeneration.
Keloids and hypertrophic scars deserve special attention. Excision of keloid scars presents many difficulties due to high density scar, the possibility of relapse of pathology. It is not recommended to cut off a keloid where there is strong skin tension, since this approach is fraught with recurrence of scarring. In addition, healthy tissue in the scar area can be used as a graft after removal of the keloid, so before surgery, all inflammatory processes should be cured, epithelial cysts and fistula tracts should be removed. To prevent subsequent inflammation, superficial sutures are applied that do not affect the dermis.
Step-by-step scar removal is carried out when it cannot be removed without damaging the tissues located nearby, due to large sizes or deep penetration into the dermis. This method is used to excise keloid scars, post-burn and post-traumatic injuries.
The technique of its implementation includes the usual removal of the scar with the only difference that it occurs in parts. At each stage, the surgeon cuts through the tissue and moves the skin, closing the resulting wound. There may be several such removals, but if the scar is too large, then as an alternative, surgeons can perform skin augmentation to reduce the number of operations.
In addition to those listed, there are other types of scar plastic surgery. For example, Z-, W-plasty, cosmetic suture. Z-plastic is needed to change the direction and configuration of a long scar, which breaks symmetry, deforms the tissue, tightens it, and it is also used for webbed scars.
With Z-plasty, the surgeon moves the skin in the form of triangles so that the scar is located along its natural lines. With this technique, you can increase or decrease the length of the scar, hide it with hair, remove membranes, and restore symmetry to the face.
The technique of the operation includes several stages:
- At an angle of 60 degrees to the scar, markings are applied in the form of lines, the length of which is approximately equal to that of the scar, thus obtaining something like the letter Z;
- The scar is removed, incisions are made according to the markings, and then the flaps of skin are shifted to again obtain a Z, but in a different direction;
- Cosmetic suture application.
Z-plasty
The described plastic surgery can be performed on several scar areas, which will reduce skin tension, and the newly obtained scars will be less noticeable due to their location in the natural skin lines. This technique also has contraindications, in particular keloids, the removal of which in this way will make the cosmetic defect even more noticeable.
W-plasty
W-plastic scars has indications similar to the previous treatment option, that is, long, symmetry-breaking, deforming, tightening scars, but it has one characteristic advantage: The resulting scar will not be longer than the original one. This plastic surgery is performed faster than the previous method, but the effect may be worse due to the fact that it is visually easier to guess in which direction the new scar will go.
Indications for W-excision are long scars that are located at right angles to the natural lines, as well as scars on the face (jaw, cheeks, forehead), tightening scar changes. An obstacle to the use of the method may be insufficient elasticity of the skin, which makes it difficult to accurately compare the edges of the wound.
The W-method technique consists of carefully marking out which will reveal triangular-shaped skin flaps after the original scar has been removed. Next, the surgeon excises the scar and connects the marked “triangles”, avoiding tissue tension.
Video: surgical removal of a keloid scar
Postoperative period and recovery
Postoperative management of the patient plays no less important role than the operation itself and its type. After excision of the scar, a pressure bandage is applied to the wound to compress the vessels and stop bleeding, which is removed the next day. As much as possible long time you need to protect the new scar from action sunlight, any damage, tension of the edges. Over the course of a week, bandages with regenerating agents are prescribed for the face and two for the body. After one and a half to two months, the patient can be referred for laser treatment or dermabrasion.
After any surgical scar excision technique, additional treatment with laser, peeling, and dermabrasion is possible, which help smooth the skin and make the scar less noticeable.
Complications after excision, scars arise when the surgical technique is violated, excessive haste, incorrect choice of suture material, the patient’s individual predilection for them due to the pathology of the internal organs. Inflammatory processes, suppuration, and the formation of hematomas are possible, which may require another operation.
To prevent future scarring and obtain the most beneficial results from scar correction, it is important to mark the incision lines as accurately as possible, carefully align the edges of the new incision, and not tighten the sutures too tightly. In addition, patients should know that in the case of scarring, time plays the opposite role: it is never too late to eliminate scars, but premature treatment and haste can lead to hypertrophy, keloid formation and skin deformation.
Excision of facial scars is represented by activities plastic surgery aimed at eliminating cosmetic defect using various techniques, the choice of which depends on its characteristics and location. The scar itself is a dense connective formation formed during the process of tissue regeneration after:
- surgical intervention;
- damage skin;
- inflammatory processes;
- ulcerative lesions.
It is mainly composed of fibrillar protein, which forms the basis of the connective tissue of the human body and is known as collagen. It is visually different from the tissues it replaces and is not as functional. They resort to removing scars on the face and body because they stand out against the background of healthy skin and spoil the appearance, often being a source of complexes and psychological problems.
Excision of scars (keloid, atrophic) - on the face (1cm) - RUB 14,000.
Excision of scars (keloid, atrophic) - on the body (1cm) - 8,000 rubles.
Included in the price:
surgery, consultation with an anesthesiologist, anesthesia/anesthesia, hospital stay with meals, dressings, postoperative observation by the attending physician for a month.
1-3 days in hospital
Removal of scars on the face and body in Moscow
Modern plastic surgery offers effective techniques for removing scars on the body and face. You can order services in this area at the plastic surgery department of CELT.
The Institute of Plastic Surgery and Cosmetology offers modern effective methods for correcting scar-deformed tissue on any part of the body, including scars after cesarean section. Plastic surgery of scar formations involves removing the deformed area of tissue, followed by re-suturing. Of course, a new scar is formed in place of the old scar, but thanks to a special technique it turns out smoother and neater.
Indications and contraindications for scar plastic surgery
Scar plastic surgery can be performed if:
- at the site of surgical access or suturing after injury, hypertrophic scars have formed - protruding, bright in color;
- atrophic scars - retracted, forming a depression in the skin, often pale;
- keloid scars - such scars tend to grow and in some cases increase in volume up to several times compared to the original condition;
- The patient has post-traumatic scar deformities of the skin and mucous membranes.
Scar plastic surgery has virtually no contraindications, since it does not involve extensive tissue mobilization and, in fact, is not stressful for the body. However, it is not recommended to perform scar plastic surgery in the presence of diseases of the cardiovascular and respiratory systems, or blood diseases.
Correction technique: surgical excision of scar tissue
Surgical removal of scars is the most radical way to get rid of them. This procedure is usually carried out with local anesthesia, however it is possible to use general anesthesia– if the scar is too extensive and deep, and its excision requires a lot of time.
The surgeon excises the scar-deformed tissue and then applies cosmetic sutures, since only such sutures allow for the most aesthetic healing.
After the tissue has re-healed, laser skin resurfacing or any other method of hardware cosmetology can be used to consolidate and improve the result.
Rehabilitation
After excision of scars, it is painless and quick: during the operation, the tissue does not peel off, and the damage is very limited. Therefore, all you need for a quality recovery is to follow your doctor’s recommendations.
The skin is a seamless organ. When the skin is damaged from a burn, cut or tear, the body heals it by forming scar tissue.
The scar can range from almost invisible to obvious and disfiguring. Unsightly scars can be wide, sunken, red, raised, or pale. They are different in color or texture from surrounding healthy tissue and may be especially noticeable because of their size, shape, or location.
The appearance of a scar is affected by:
- depth and size of the wound,
- blood supply to the area,
- skin thickness and color,
- direction of the scar,
- age,
- genes,
Every person heals differently and scars are always unique.
When the skin is in the process of recovering from injury, whether the result of an accident, surgery, burns or acne, scarring (formation of connective tissue) will occur where multiple layers of skin have been affected.
Scars are not elastic, they do not contain sweat and sebaceous glands. Without treatment, they sprout blood vessels after 3 months. Once a scar forms, it remains forever. Severe burns that destroy large areas of skin heal by tightening the skin. It can even affect muscles and tendons. Scars are divided into normal and pathological. Normal scars are level with the surrounding skin or slightly retracted. Pathological ones include keloid and hypertrophic scars.
There are many plastic surgery techniques to treat and improve appearance scars. The scar cannot be completely removed, but it can be reduced in size and changed in appearance, making it less noticeable.
Scar tissue correction surgical techniques aim to smooth out the scar and make it as invisible as possible. The procedure involves recreating the incision, moving the surrounding skin, or even repositioning the scar to make it less noticeable. For each specific scar, revision surgery options are considered depending on where it is located and what its nature is. Treatment can also help relieve tension caused by scar tissue.
Treatment options may vary depending on the type and extent of scarring and may include:
- conservative local treatment,
- minimally invasive procedures,
- surgical intervention.
A combination of techniques is often necessary to achieve the best results.
Preoperative consultation
The surgeon examines the scar to decide on appropriate treatment and informs the patient about the results that can be expected from the surgery.
Scars are very individual, so more than one type of technique may be used to maximize scar improvement.
The surgeon may initially offer less invasive methods Treatments to minimize scarring include laser resurfacing, steroid injections, and silicone dressings. However, some scars can only be removed surgically. Many patients want to combine scar removal with another plastic procedure.
The timing of the operation is another important choice. Many plastic surgeons recommend waiting a year or more after an injury or surgery before having scar removal surgery. This interval gives the body enough time to fully heal. Many scars that appear large and unsightly at first may become less noticeable over time.
Scar removal surgery is generally safe, but there is always the possibility of complications. These may include infection, bleeding, a reaction to the anesthesia, or re-formation of an unsightly scar.
Types of scars and methods for their correction
Keloids are scar tissue that grows beyond the edges of the original wound or incision, causing pain.
Keloid scars are the result of overproduction of collagen in the skin.
These scars usually appear as growths. They often have red or dark color different from the surrounding skin. Keloid scars can appear anywhere on the body, but they are most common over the breastbone, earlobes, and shoulders. The tendency to develop keloid scars decreases with age.
Small keloid scars can be treated with cryotherapy (freezing with liquid nitrogen). You can also prevent keloids by using silicone gel strips after an injury. Keloid scars are often treated with steroid injections directly into the scar tissue to reduce redness, itching, and burning. In some cases, this helps reduce the scar.
If steroid treatment is not enough, scar tissue may be removed and the wound closed with fine stitches. This is usually an outpatient procedure and is performed under local anesthesia. The patient will be able to return to work the same day, and the stitches will be removed within a few days. Skin grafting is rarely used. However, keloid scars may return, requiring repeat treatments over several years.
Enlarged (hypertrophic) scars
Hypertrophic scars are often confused with keloid scars because they are similar in appearance: rough, red, and higher than the level of the surrounding skin. Hypertrophic scars, unlike keloids, form within the original incision or wound, but due to their dense texture, can be unsightly and can also restrict the natural movement of muscles and tendons. The appearance of hypertrophic scars often improves on its own, although this may take a year or more. Hypertrophic scars can be improved with steroid injections or silicone dressings.
If conservative approaches are not effective, hypertrophic scars can be improved with surgery. This surgery can be performed under local or general anesthesia, depending on the location of the scar. The patient may receive steroid injections during surgery and as a preventive measure periodically for two years after surgery.
Scar contractures
Burns and other injuries result in the loss of a large area of skin and can form a scar that pulls the edges of the skin together. As a result of skin tightening, contracture can form - restriction of normal mobility of the joint, tendons, and muscles.
Correcting contracture usually involves removing the scar and replacing it with a skin graft. Skin flaps from adjacent healthy, intact skin are lifted and repositioned to create a new incision line. If relocation of adjacent skin areas is not possible, a skin graft may be used. In some cases, a technique known as a Z-plasty may be used. If the contracture has been present for some time, patients may need physical therapy after surgery to restore full muscle and tendon function.
Acne scars and stretch marks
Acne is one of the most common skin diseases. Severe acne usually leaves scars and scars. There are several types of acne scars, such as raised, indented, and holey. Treatment options depend on the number and type of scars from acne.
Stretch marks form when the skin stretches quickly, such as during pregnancy and weight gain. They occur when the volume of the body increases faster than the skin stretches to accommodate this volume. For stretch marks connective tissue compensates for skin deficiencies. Laser treatment may help reduce the appearance of stretch marks.
Conservative methods of scar treatment
For some patients, conservative forms of therapy may be most effective.
Steroid injections are used to treat keloids and hypertrophic scars. Hormones are injected deep into the scar, which reduces collagen production. Injection of collagen or hyaluronic acid fillers may be effective for some types of scars, especially sunken, atrophic ones. This procedure does not provide permanent results and will have to be repeated every 4-12 months.
Occlusive therapy may use silicone gel and sealant dressings to soften scars. Plasters and bandages increase the pressure and temperature of the skin and moisturize it. All this increases the activity of collagenase, which breaks down collagen. The effect appears gradually, usually over several weeks or months. Silicone is effective in the beginning preventive treatment in the first 2-3 months of scar healing.
Hardware cosmetology for scar correction
Laser treatments can help reduce scar size and redness. Laser beams penetrate the upper layers of the skin and help reverse the process of scar tissue formation, reducing the size of the scar during healing. This form of treatment can reduce acne scars, treat active form acne, reduce the visibility of stretch marks.
Some scars can be smoothed using laser skin resurfacing. The laser vaporizes the surface layers of the scar, aligning it with the surrounding skin. Dermabrasion is the controlled scraping of the top layers of skin using a high-speed rotating brush. Dermabrasion and laser skin resurfacing can smooth out small scars but do not completely remove them.
Cryotherapy is based on the use of liquid nitrogen. A liquid nitrogen creates short-term cooling of the skin surface and helps smooth out scars.
Surgical methods for scar removal
Excision of scars
Improving the appearance of some scars can be achieved by simply removing the scar tissue and re-closing the wound. If there is enough skin adjacent to the scar, surgical excision removes scar tissue, then the edges of the skin are carefully sutured. As a result, instead of a scar, a thin, less noticeable scar remains.
Z-plasty
Z-plasty is surgical method, which is used to redirect the scar so that it more closely follows the natural lines and folds of the skin and is less noticeable. Not all scars are amenable to Z-plasty.
With this procedure old scar excised. New incisions are made at each end of the scar, at an angle of 60 degrees to the scar and equal in length, creating small triangles of skin. These triangular sections are then rearranged, reversing them to cover the original scar at a different angle, resulting in a zigzag incision shape. The wound is closed with small stitches, which are removed after a few days. Z-plasty is usually performed under local anesthesia.
With multiple Z-plasty, to improve scar camouflage, the Z-plasty skin flaps are made small. As a result of their connection, a broken scar is created, and the tension is redistributed in several directions. Multiple Z-plasty is used to reduce scar contracture.
W-plasty
In W-plasty, small successive triangular segments of skin are excised around the perimeter of the scar. Then the opposing flaps of skin are aligned with each other in the form of teeth and the wound is closed. With W-plasty, the scar does not lengthen significantly.
Skin graft
Skin graft transplantation is serious method removal of scars. In this case, the scar is excised, and skin from another (donor) area of the body is used to cover this area. This method is effective for large scar areas; it is often used for burns. The operation is usually performed using general anesthesia. The transplant leaves small scars on both the donor sites and the transplant area.
Patchwork plastic surgery
Flap surgery (pedicled skin flap surgery) is a complex procedure in which the skin, along with subcutaneous fat, blood vessels, and sometimes muscles, is moved from a healthy area to a damaged one. In some cases, the blood supply remains dependent on the donor site. In other cases blood vessels The skin flap is connected to the vessels in a new location using microvascular surgery.
The cosmetic results of skin grafting can only be satisfactory, since the grafted skin may not exactly match the color and texture of the surrounding skin.
Flap surgery provides better cosmetic results than skin grafting.
After operation
Patients may feel some discomfort after scar removal. Swelling, bruising and redness are usually inevitable.
Surgeons usually insist on reduced activity after surgery. Patients in the supine position should keep their head elevated. Cold compresses can be used to reduce swelling. Any activity that places excessive stress on the incision area should be avoided.
The patient should keep in mind that the scar cannot be completely removed. The degree of improvement depends on the size and location of the scar, the properties of the skin, and the quality of wound care after surgery.
It is important to remember that scars take a year or more to fully heal. After the initial active healing phase, the wound reaches a maturation phase where the scar becomes less dense and red. Over the course of 6-12 months, the scar tissue matures and stabilizes.
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