Scar reconstruction and scar revision aim to improve selected scars that are raised, widened, tight, painful, itchy, unstable or functionally limiting. Scars may follow surgery, trauma, burns, acne, infection or piercings.
No treatment can remove a scar completely. The realistic goal is improvement in symptoms, position, contour, function or appearance where possible.
Different scar types require different strategies. Keloid scars, hypertrophic scars, contractures, depressed scars and widened scars behave differently and have different recurrence risks.
This page provides general information and should not replace consultation with a qualified medical practitioner. Suitability, risks, recovery and outcomes vary between individuals.
Types of scars assessed
Assessment begins by identifying the scar type and the patient’s main concern.
- hypertrophic scars that are raised but remain within the wound boundary
- keloid scars that grow beyond the original wound and may recur after treatment
- widened or stretched scars
- contracture scars that restrict movement
- depressed or tethered scars
- unstable or painful scars
Consultation and planning
Consultation includes scar history, cause, duration, symptoms, previous treatments, skin type, keloid tendency, scar location and whether function is affected.
A young, active scar may need non-surgical management first. Mature scars that remain problematic may be considered for revision or combination treatment.
Treatment options
Options may include silicone therapy, pressure therapy, steroid injection, other injections, laser treatment, surgical scar revision, release of contracture, fat grafting in selected tethered scars, or combination therapy.
Keloids require particular caution because excision alone may recur. A combined recurrence-reduction plan may be discussed depending on scar location and patient factors.
Recovery and scar maturation
After scar revision, the new scar still needs to mature. Redness, firmness and sensitivity can persist for months. Scar care, sun protection and follow-up are important.
Patients prone to keloids or hypertrophic scars may need prolonged monitoring and additional treatment.
Risks and limitations
Risks include recurrence, worse scarring, infection, wound breakdown, pigment change, contour irregularity, pain, numbness, incomplete improvement and need for repeated treatments. Keloid recurrence is a particular limitation.
FAQs
Can a scar be removed completely?
No. Scar revision replaces or modifies a scar; it cannot make skin completely scar-free.
Why do keloids recur?
Keloids are driven by abnormal scar biology. Even after removal, the skin may form another keloid, so combination treatment and follow-up may be needed.
When is scar revision considered?
It is often considered after a scar has matured, unless the scar is causing functional restriction, breakdown or significant symptoms that need earlier attention.
Related pages
Enquire about assessment
If you would like to discuss whether this procedure or treatment area is relevant to your situation, please submit an enquiry. A formal consultation is needed before any personalised advice can be given.