Scar revision at Plymouth Hospital

What is scar revision?

Scar revision is treatment to improve how a scar looks, or to ease pain, tightness or itching it may be causing. It cannot erase a scar completely, but it can help it fade, flatten, or blend in better with the skin around it.

What does it treat?

Scar revision can help with scars from a range of causes, including:

• surgery, caesarean birth, or cleft lip repair
• accidents, burns, or other injuries
• severe acne, piercings, or skin infections.

What are the benefits of scar revision?

Depending on your scar, treatment can improve:

• its colour, size, texture and thickness, helping it blend in with the surrounding skin
• any tightness, pain or itching it causes, and the range of movement in the area
• your confidence and comfort in situations where the scar has been on show.

Are there different types of surgical approaches?

Yes. Non-surgical options include creams and silicone sheets, pressure dressings, injections into the scar, freezing treatment, and resurfacing with lasers or dermabrasion; these suit milder or newly formed scars and are often tried first.

Surgical options are used for larger, tighter, or more established scars. Some are simply cut out and closed with careful stitching. Others use a zigzag or interlocking cutting pattern to redirect or break up the scar so it is less noticeable, or to release a scar that is pulling on the skin and restricting movement. Very large scars, or those with a lot of tissue loss, may need a graft or flap of skin borrowed from another part of your body.

What happens before the operation?

Before treatment, you can expect to:

• wait for the scar to mature, usually 12 to 18 months, since scars revised too early tend to give a poorer result
• eat well, with plenty of vitamins A, C and E plus zinc, since these support wound healing
• stop smoking, ideally for six weeks before and after surgery
• pause blood-thinning medication, aspirin, anti-inflammatory drugs and certain herbal supplements beforehand, if your specialist advises
• flag any diabetes, weakened immunity, or acne medication to your specialist, as these can affect timing and healing.

What happens during the procedure?

1. You have a local anaesthetic for a smaller scar, or a general anaesthetic if the scar is larger or more complex.
2. The surgeon cuts away the existing scar tissue.
3. For a straightforward scar, the edges are simply brought back together and closed.
4. For a longer or more visible scar, the surgeon may use a zigzag or interlocking cutting pattern instead, to break up the line and help it blend in.
5. If there is not enough healthy skin nearby to close the wound, a graft or flap of skin from elsewhere on your body may be used.
6. The wound is closed with fine stitches, chosen and placed to keep tension off the healing skin.

What does recovery look like?

Most scar revisions are done as a day case, so you go home the same day. You can move around normally straight away. Please discuss with your team about when you can shower and drive again. Many people are back at their desk within a day or so, while more physical jobs may need longer.

Keep the area out of strong sunlight for at least the first two weeks, and cover or protect it with a high-factor sunscreen for around a year afterwards, since sunlight can make a healing scar redder, thicker and more noticeable. Gentle massage, once the area is comfortable, and a gradual return to exercise over two to six weeks both help the healing process. The final appearance of your scar can take several months, sometimes up to a year, to fully settle.

What are the risks and complications?

Every procedure carries some element of risk, and scar revision is no exception. Possible risks include:

• bleeding, a build-up of blood beneath the healing skin (haematoma), or a build-up of fluid there instead (seroma)
• infection or slow wound healing
• an uneven final result in texture or shape
• the new scar becoming thickened, raised, or (in those prone to it) developing into a keloid scar
• darker or lighter skin around the treated area
• an unwanted reaction to the anaesthetic, or, rarely, a clot forming in a vein.