In-depth consultations directly with an NHS trained consultant surgeon
Surgeon-led and managed care throughout for a truly personalised approach
Walk in and walk out the same day with anaesthetic techniques adopted from the USA
Comprehensive aftercare programme
Scar revision prices start from £1250 all-inclusive
Financing options available
Call us on 020 7993 4849 / 0900 – 1730 Mon – Fri
Every time the skin is cut or damaged through its full thickness it will heal with a scar. Some people naturally make better scars than others. We cannot accurately predict this but in general we are aware that patients with a black skin and at the opposite end of the spectrum patients with fair freckled skin and red hair will tend to produce poor scars including hypertrophic scars and keloids.
Certain areas of the body produce worse scars than others. The worst area being the middle of the chest which can on rare occasions produce keloids spontaneously without any known injury. The tip of the shoulder is poor, but fortunately the face and neck make good scars generally.
Scars which lie in the lines of skin tension tend to be better than ones that run across them. Surgeons will try and choose a good site and direction, but if the scar is due to an injury, there is no choice. A good site for a scar is a hidden site, such as the arm pit for carrying out liposuction of the chest.
- Pressure which can be from a bandage or a pressure garment which would be made of some sort of stretchy material such as Lycra or Tubigrip. This pressure should be applied day and night for many months or even years.
- The application of silicone. Usually in sheet form directly to the wound is thought by many to speed up maturation of the scar.
- Steroids. The simplest is the application of a steroid containing tape (Haelan tape) which is worn day and night for extended periods. Strong steroids such as Triamcinolone (Kenalog) can be injected into the scar itself. It is usually given as a course at 4 to 6 week intervals. Severe keloids may regress with this treatment but later recur requiring further injections.
Centre for Surgery perform the full range of treatments for scar revision:
- Surgical treatments
Scar revision surgery (excision, release and approximation).
Skin and soft-tissue flaps.
Tissue expansion (skin expander treatment).
Skin grafting (split-thickness and full-thickness).
- Fat transfer
Microsurgical fat grafting.
- Non-surgical treatments
Topical scar treatments.
TCA skin peels.
1. Post-traumatic scars: the typical facial scar originating from accident, disease or surgery usually only requires a simple surgical revision, re-positioning of tissues (to match natural facial lines and contours) and careful approximation. For superficial post-traumatic scars, acne scars and stretch marks, microneedling therapy (Dermapen), laser treatment, TCA skin peel, dermabrasion or fat grafting, may provide satisfactory softening and improvement.
2. Burn scars: burns often destroy larger sections of skin and cause it to heal in a puckered manner (contracture). Surgery involves excising the scar tissue entirely (if possible). Skin flaps, composed of adjacent healthy unscarred skin, are lifted and moved to form a new incision line. Where flaps are not possible, tissue expanders or split-thickness/full-thickness skin grafts may be used.
3. Hypertrophic scars: raised hypertrophic scars do not extend beyond the boundaries of the original wound as seen in keloid scars, but because of their thick texture, can be unsightly and restrict movement of underlying muscles. The excess scar tissue is removed, re-positioned, and made to heal in a less-visible fashion.
4. Keloid scars: keloids are a result of the skin’s overproduction of collagen after a wound has healed. These scars overgrows the original wound, and look like exaggerated scars, raised above the skin. Surgery involves the removal of the hard fibrous collagen within the scar, and then closing of the skin. Following the procedure, the scar needs monitoring for signs of keloid recurrence, as preventative measures can be implemented (pressure treatments, silicone gel pads, and steroid injections).
5. Atrophic scars: sunken fibrotic scars represent the opposite of a hypertrophic scar. These scars can range from slightly depressed to completely indented, with reduced soft-tissue substance and occasional adhesion to deeper tissues. This type of scar generally responds well to surgical release combined with fat transfer.
Scar revision can benefit any person with functional and aesthetic concerns related to facial or body scarring – independent of age or skin type. Procedures are performed in local anesthesia or with intravenous sedation (TIVA). Due to the extensive number of scar types, the choice of revision is best reached in consultation. The most satisfactory results are usually achieved by combining treatments.