This page explains how a troublesome scar can be reshaped, repositioned or released. It also sets out the two things patients most need to know, that a scar can be improved but never erased, and that timing changes the result.
Scar revision surgery replaces a wide, tight or badly placed scar with a neater one that sits in a better line. It cannot erase a scar, since any cut in the skin heals with a mark. Timing matters, because many scars soften on their own for a year or more, and operating too early can give a worse result.
Scars trouble people for different reasons. Some are wide or raised, some pull on a joint or an eyelid and limit movement, some sit at an awkward angle across the face, and some are simply darker or more sunken than the skin around them. The first job at consultation is to work out which of these is really bothering you, because the technique follows from that.
The straightforward approach is to excise the old scar and close the skin again in careful layers, so the new scar is thin and sits in a natural crease. A tight band across a joint may instead be released and rearranged, using techniques such as a Z plasty that change the direction of pull. Where a large area needs replacing, healthy skin can be grown next door with a tissue expander over several weeks and then moved across.
Timing is part of the plan, not an afterthought. Recent scars often keep improving on their own as redness fades and tissue softens, so surgery is usually delayed unless a scar is restricting movement. Waiting also lets simpler measures like silicone, massage and sun protection do their share of the work.
The scar is examined for width, height, colour and pull, and photographs are taken. You are told whether to operate now or to wait while the scar matures, since many settle well on their own.
Markings are drawn so the new scar follows a natural crease or the border of a facial feature. Where a band pulls tightly, the design changes the direction of tension instead of simply removing tissue.
The old scar is cut out and the wound is closed in layers, with deep sutures taking the tension off the skin. Fine sutures at the surface leave the narrowest possible line.
For tight scars a Z plasty or a local flap moves healthy tissue in and lengthens the scarred area. Staged tissue expansion is used when a large patch of skin needs replacing.
Dressings, taping and later silicone and massage protect the young scar while it matures. Sun protection is stressed at every visit, because a fresh scar darkens easily in strong light and can stay dark for months.
Some swelling, bruising and tightness are normal. Dressings stay dry, and simple pain relief is usually enough for most people.
Stitches are removed and the new scar looks red and firm, which is expected at this stage. Taping or silicone begins, along with gentle massage once advised.
Redness starts fading and the scar softens. Normal activity and exercise are resumed, with the area kept out of strong sunlight.
The scar continues to pale and flatten for a year or longer. A review checks the final line and whether any small touch up would help.
Scar revision trades an unwanted scar for a better placed one, so a mark always remains. The possible problems are set out plainly before you decide.
The price reflects the length and site of the scar, the technique chosen and whether local or general anaesthesia is used. A short facial scar treated in day care costs far less than a staged expansion of a large burn scar. Hospital charges, dressings, silicone products and review visits are included in the written estimate you receive after assessment, and any second stage is quoted separately so nothing arrives as a surprise.
These are the questions that come up most often in consultation. If yours is not here, send it on WhatsApp and the team will reply, usually the same day.
Ask your question →It depends on the size and site of the scar, the technique used and the type of anaesthesia. Staged work such as tissue expansion costs more than a simple excision. A written estimate covering surgery, hospital charges and reviews is given after your assessment.
For most healthy people this is low risk surgery, often done under local anaesthesia in day care. Bleeding, infection and slow healing are the usual concerns. Your health, medicines and smoking history are reviewed first, since these affect how the wound heals.
Stitches usually come out within one to two weeks, and desk work often restarts within a few days. Exercise waits a little longer so the wound is not stretched. The scar itself keeps maturing for many months after that.
No. Any cut heals with a mark, so the honest aim is a thinner, flatter scar that sits in a better line and catches the eye far less. Many scars become much easier to live with, but none can be erased.
Suitability depends on the scar and on you. Scars that are wide, tight or badly placed respond best. A strong tendency to form keloids, active infection or heavy smoking may mean the plan is changed or delayed until conditions are better.
Timing matters. Most scars keep softening and fading for a year, so waiting often gives a better starting point. The exception is a scar that restricts movement or pulls an eyelid or lip, which is usually released sooner.
The scar is examined for width, colour and pull, and photographs are recorded. Your healing history and any earlier surgery are discussed. You then hear which technique fits, whether to wait, and what aftercare will be needed once healing begins.
Each technique below has its own page explaining how it works and when it is chosen.
Seeing patients from across the city and beyond: read about the practice on the plastic surgeon in Surat page, or check what a written estimate covers on the costs and insurance page.
