Scar Revision in Canada
A scar is a mark left on the skin by the healing of injured tissue. When the skin is damaged the body responds in three phases; inflammation, rebuilding and remodelling. The immune system responds immediately to fight off infection. The body produces inflammation to fight against infection. Inflammation causes an increase in the local blood supply so that large numbers of white blood cells can be brought to the damaged area to fight infection. During the rebuilding phase, the skin begins to repair the damage to help heal the wound so that it may close. Collagen fibres are produced during the repair process. Finally, in the remodelling phase, more collagen fibres are produced and organized to increase the strength of the skin.
Often, the immune system overreacts with more white cells and collagen than necessary, causing excessive scarring that is red, raised and unattractive. A scar looks different from normal skin because fibres are organized differently than in normal skin.
There are various reasons a patient may end up with a problem scar after plastic surgery. A persons medical history or some medical conditions may contribute to problem scarring. Scarring can be worse in certain races (heavily pigmented skin), certain areas (chest, shoulders, upper back, jaw line), at certain ages (younger) or if placed across lines of skin tension. Other factors could be improper cleaning or infection of the incision, injury to the incision site while healing, exposure to sunlight, poor nutrition and age.
Problem scars include keloid and hypertrophic scars. A keloid is an overgrowth of scar tissue at the site of a skin wound. The new tissue is elevated, rounded, and firm, with irregular and claw-like margins. Keloids occur most often in heavily pigmented people and tend to get progressively worse. A hypertrophic scar is a wound that heals to greater than normal size as a result of an aggressive lay down of collagen, contained in larger than normal skin cells, producing a raised, smooth, hyperpigmented result. The site maintains a higher than normal level of sensitivity and the tissue is more fibrous in structure
There are a few options available for those wanting to approve the appearance of their plastic surgery scar, some non surgical treatments include:
Vitamin E: Some surgeons suggests a patient rub Vitamin E oil on their incision site once it has closed. Some think it improves the appearance of the scar, others think it just keeps the scar moisturized but nothing more.
Silicone Sheeting: The most recognized product for reducing redness and flattening a scar is a silicone based product. Silicone sheeting is a product you can buy at your surgeons office or you may be referred to a hospital. It comes in a strip that you cut into pieces and stick onto your scar. These pieces need to be replaced every 10 days or so.
Silicone Gel: You can also buy a silicone product in a gel form. The gel has similar properties as silicone sheeting but dries in a thin layer acting like an extra layer of skin.
If a scar does not respond to the above treatments there are some other procedures a plastic surgeon may offer. A scar revision may be performed, where the surgeon basically cuts away the old scar and restitches the incision.
Cortisone injections or laser treatment may also be available. Your plastic surgeon would be able to suggest the right action for you to take.
discuss your particular situation in more detail, consult with a
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