Scar excision is a surgery in which a scar is either removed or modified to improve cosmetic appearance. Damage from injuries, wounds, or surgeries sometimes alter skin appearance and interfere with the function of certain parts of the body. There are various kinds of scar excision. These surgical procedures can be done when the patient is completely awake, using local anesthesia, or is under either light sedation or general anesthesia.
The level of anesthesia used depends on what the surgery involves. Small scars can be fixed using local anesthetics. A scar can often be completely removed, and the surgical wound is then closed so that the scar does not return. Dermabrasion is a common technique in which a wire brush is used to take off the top layer of skin. This can scale down raised scars and allow for new skin to grow over the area.
Another form of scar excision is skin grafting. It is used when thin scars do not heal or when a lot of skin has been lost to an injury. Skin is taken from another part of the body along with blood vessels, nerves, and muscle, and then attached to the injury site. Grafting is beneficial for returning as much function as possible, but does not always lead to dramatic improvements in appearance.
Scar removal is also accomplished with a shave excision, during which an elevated scar is cut with a blade or scalpel. During these operations, the surgeon does not enter the deep layers of skin, and the wound is left to heal on its own. An elliptical excision is performed on large, thick scars called keloids. The surgeon cuts deeper into the skin during these medical procedures, and sutures are placed beneath the skin to avoid excessive swelling afterward.
A Z-Plasty is performed on long linear, contracted, or webbed scars to align them with the direction of the skin’s tension. During a W-Plasty the length of the scar is not changed, and triangle-shaped skin flaps are made and brought together after the scar is excised. Other scar excision techniques can involve using various geometric shapes, the use of a punch tool for wide box-shaped scars, or cutting fibrous tissues to stimulate the creation of new connective tissue under the scar.
It is always possible for a scar to reform after a scar excision. Dermatologists must determine the best technique to use with each procedure. They can also combine different techniques depending on the scar to achieve the best possible results.
