Scar correction

Scar formation is an inevitable consequence of any skin damage. This problem is rather pressing for many people. Scars appear practically after any break of the skin integrity, after surgical interventions in particular. Unfavorable healing conditions and improperly closed wound frequently lead to the formation of coarse, ugly scars that bring psychological and aesthetic discomfort. When scars are located in visible areas, this worsens a patient’s life quality.

If a scar appears on a human body, this is, unfortunately, forever. Therefore, if anyone promises you to remove a scar, such a promise is either an elementary illiteracy or a dubious way to lure you. Here we can only speak about the improvement of some characteristics of a scar, e.g. reducing its width to make it less conspicuous. In some anatomic areas this task is solved more easily, while in other (where the skin tension is higher and where there is no possibility of simultaneous scar resection) it may require a complex and multistage operation.

Correction of the rising (hypertrophic) scars requires not only their resection but, in some cases, the transformation of a straight scar line into a zigzag one and the use of Z-plasty to change a scar vector in order to reduce the load on some scar areas thereby improving its quality.

Removal of extensive scars via extending (elongating) the adjacent skin is used when the existing skin is apparently insufficient to resect the scar and it is impossible to approximate wound edges without tension. In these cases a special bag (tissue expander) is placed near the scar, and its volume is gradually increased via injecting sterile solution into a special port. The skin covering this device is gradually extended, and its abundance makes it possible to resect the scar and consequently close the wound without strong tension, this being of much importance for the formation of a considerably thinner scar.

Complete scar formation takes 4–9 months and depends on the skin individual features, localization and character of a trauma, care of the damaged area. At this period a surgeon’s consultation is advisable to receive recommendations on the correct care of a scar being formed. Scars are extremely various, and their formation is influenced by many factors.

• Skin color: people of the black race are more prone to keloid formation; in some European people, e.g. in those having red and fair hair, the risk of formation of red hypertrophic scars is above the average.
• Age: skin elasticity and scar tissue activity decrease with age, and scars tend to become less conspicuous; in young people, on the contrary, the scar tissue activity is higher and more likely forms a solid red scar;
• Scar localization: the thinner and less elastic is the skin, the thinner, as a rule, is a scar, this being one of the reasons why on the eyelids the surgical “traces” are most delicate. The worst skin healing is found in the sternal projection, on shoulders and back, where the formation of keloid and hypertrophic scars is more probable;
• Incision line vector: a human body has natural folds covering the whole of its surface in parallel with the so-called Langer’s lines. A scar running in parallel or within one of these lines, is always less conspicuous, and in the cases where a scar crosses the Langer’s line, the scar being formed extends longitudinally, becomes more coarse and protrudes above the skin surface forming a hepertrophic scar;

  

• Wound edge tension: in the areas where a wound is closed with a strong traction of its edges, a wound and a scar experience daily tension during 3 postoperative months, this scar acquires much more tendency to be tensed and transformed into atrophic non- cosmetic scar.

Any human possesses his/her own intrinsic peculiarities of forming the scar tissue. That is why under equal conditions some patients form a thin slightly conspicuous scar, whereas others form a coarser scar that attracts attention. In extreme cases (fortunately, rather rare) keloid scars may be formed. They considerably rise above the skin surface, have a reddish or bluish tint, may cause etching and are prone to grow independently.

To correct the already formed scars, the “Medical Club” clinic runs a comprehensive treatment program. We use physical, medicinal and surgical correction methods, and, most frequently, a combination thereof: surgical scar resection with suture placement; various local plastic operations; modeling of the skin stock using an expander, with consequent substitution of a scar defect; microdermabrasion; laser resurfacing; laser scar color correction; cryotherapy; injections of corticosteroids; special silicone plates. All the above used in complex enable the external scar characteristics to be maximally improved.

Of much importance during surgical scar correction is the wound closure technique. If the external sutures are removed (in the absence of internal sutures), the wound edges fall apart making a scar broader. Thinner and cosmetic scars are formed after placing the internal, skin relaxing sutures developed and patented by us (Patent No 34072 of 25.07.2008).

These sutures, in combination with a non-removable intracutaneous suture, hold the wound edges for a long time thereby promoting the formation of a thin cosmetic scar.

Contraindications to scar correction are:

• Acute inflammatory processes on the skin;
• Pronounced couperose;
• Inflammatory processes in the area where correction is performed;
• Herpes in an active phase;
• Atopic dermatitis;
• Aggravation of somatic diseases

• In the “Medical Club” clinic scar correction is performed under a general anesthesia. In some cases, isolated small scars may be corrected under a local anesthesia. The choice of anesthesia is to be agreed upon with a surgeon and an anesthesiologist in advance.
• The duration of operation will depend on a scar mass and correction method, and may last from 30 minutes to 2 hours.
• A stay at the clinic is several hours, on the average, or 24 hours in rare cases.
• Sutures are removed very rarely.
• Next day approximately you will be able to resume your usual life.
• You are not recommended to attend sauna, solarium and fitness centers within a month.
• An ultimate result of operation may be assessed in 6-9 months.

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