Scar Revision / Scar Repair Questions and Answers

Search: 

Question:

I'm also wondering how the scars would be repairable. Would this mean skin graphting?? My scars are quite wide and have a brownish color to them. I'm also scared to be cut again because I don't want to end up with an infection again, would that happen? Is there any guarantee that the scars would be unnoticable? Or am I taking a chance again? Thank-you for your help, it's greatly appreciated.. Jody Bryan

Answer:

Dear Jody, It is largely because of the infection that the scars are unsightly. There is no reason to believe that you would get an infection again with the revision but there would be no guarantees.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

I had a tummy tuck in 1994. The next year, 1995, I had to have a hysterectomy. The cut made for the hysterectomy was on top of the previous scar from the tummy tuck. It left a terrible purple, wide scar. What can I have done to make it look better? Would a scar revision be in order?

Answer:

Dear Beverly, A scar revision is all that is needed. Both scars would be removed and a new scar made which would, likely, heal in an acceptable manner, much like after your first procedure.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

I had a breast reduction done in July of 2000, and my scaring is unbelieveable!!When I went in to see the surgeon before my surgery date was set, he explained what would be happening and he also sent me to consult with a nurse. She also told me of the procedures and then the day of my surgery nothing happened the way it was supposed to. I ended up getting an infection and ended up in the hospital in my home town for a week. The scares are very ugly and I am very disappointed in the way that they look. My husband describes it as a "hack job." Is there anything i can do about this legally?

Answer:

Dear Jocy, Breast reduction surgery involves long scars. The scars are likely not of the best quality (thin, white lines) mostly because of the infection. Scars that become "hypertrophic", that is, thick, red or wide, can often be significantly improved with scar revision surgery. I am certain that your plastic surgeon would like to see you again in order to review the options. Unfortunately, infections and bad scarring is unpredictable and a risk of the surgery. I would suggest that you seek to improve the scars rather than legally try to receive compensation for them being unsightly.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

My 14-year old daughter needs scar revision for a scar that runs from temple to temple just behind the hair line. The scar is a remnant of surgery at 4 months of age to correct craniosyntosis(fusing of the plates of the skull on the right temporal side). She had corrective surgery at age 11 to try to revise the scar and fill in a concave area on the right temple with porex. The scar is instead wider and the porex implant may need to be trimmed back to give a more symmetrical appearance. I am looking for a surgeon or surgical group that has extensive experience with this type of problem. Thank you for any information or referral you can provide. This is covered by our insurance which has a nationwide network so we are willing to travel wherever it takes to get the proper attention to this problem.

Answer:

Dear James, The scar revision and skull contouring should be able to be corrected by any plastic surgeon with additional training in craniofacial procedures. I would suggest that you contact Dr. Henry Kawamoto in Santa Monica, CA (310) 829-0391 who may be able to refer you to someone competent closer to your home.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

On july 10th I had moh's surgery under my left eye, it was quite extensive and I've been left w/ a diagonal scar under my left eye beginning 1/4 of an inch under my tear duct and going towards my left ear. The scar is approximately 2 inches in length and I am having dermabrasion on the 19 of Sept. I would like to know what to expect, will I be in any discomfort, will it swell, and how long does it generally take to heal. Thank you for your time. I have visited a website on dermabraision and did get some information but I guess I feel I just need a little more positive thoughts. Thanks again.

Answer:

Dear Margaret, I understand that you will be having dermabrasion on this scar. If the scar is narrow and not too depressed, this may help a little. In that area, dermabrasion is not the best treatment since the lower eyelid skin is very thin and fragile and does not lend itself well to mechanical abrasion. I would suggest that you visit with a plastic surgeon in order to explore the possibility of either scar revision if the scar is wide or thick and, if optimal from that viewpoint, laser resurfacing so that an adequate depth of resurfacing can be performed without danger to this very thin skin or your eye.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

I am a 36 yr old,three children, that has had gallbladder surg. which resulted in a incisional hernia which was repaired twice with failure , finally the third time was repaired again with mesh. After this surgery i have what looks like a fat roll but have never had that before. Could it be scar tissue? I also have had four bikini cuts due to ovarian cysts surg. I have done many things to try to flatten my tummy again with no satisfaction, If i had a tummy tuck how much recovery time will that take and would insurance cover the hernia scar tissue issue? What would be the right way to approach my insurance about this before consultation or involve the doctor i choose? Thank you for you time- Robin

Answer:

Dear Robin, You certainly have had a number of problems in your abdominal area. I would suggest that you visit with a plastic surgeon who can determine if there is significant herniation and if your risk vs benefit is in favour of performing a modified abdominoplasty procedure. A true abdominoplasty is likely out of the question with the amount of surgery that you have had and the scarring that is present. He/she should be able to approach your insurance company to determine what will be covered by your policy prior to the surgery.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

I had a tubal reconstruction done 7 months ago, I have been having unprotected sex since then, but I have not become pregnant. They were only able to repair the one side through the surgery. My period is irregular and I have no idea how many days my menstral cycle is. Could you please tell me how I can chart my ovulation and when would be the best time to get pregnant. Thank-you

Answer:

Hi, If your periods are irregular, then you're not likely ovulating properly. If this is true, this would make it harder to get pregnant, increase your odds of a miscarriage, and make it hard (if not impossible) to chart ovulation. Assuming you had your surgery by a qualified reproductive endocrinologist, you should contact your RE and discuss testing to find out why you have irregular cycles, along with what the proper medication would be to help you ovulate and conceive. I hope this makes sense.... Good luck! P.S. - I also hope they told you about an increased risk of ectopic pregnancy. Scott Roseff, MD, Director W.E. C.A.R.E. Visit us at www.reproendo.com ======================================== The information herein should be used for educational purposes only, and should never be used as a substitute for medical advice/care by your healthcare provider. Dr. Roseff assumes no responsibility for any actions taken (or not taken) by you due to the information contained herein. =========================================

Question:

Thank you again for your previous detailed response. I've consulted with the same doctor who gave us the information in my last message and he feels the second approach with the incision in the hairline, under the eye and in the mouth can be performed without cutting under they eye at all. I've looked up several published papers and notes on the subject, but can't seem to find a wealth of info online about this method. This would be ideal for us! Have you heard of this method and its results and do you have any additional information on this method? -Melisa

Answer:

Dear Melisa, The access by either route would yield, in almost all circumstances, excellent scarring. The coronal scar is an excellent one within the hair and usually is almost imperceptible. The three scar access may actually lead to more scarring on the more visible areas of the face than the former scar noted. Yes, if the bone is not in the proper position by that amount, it should be repaired so as not to impinge on the muscles of mastication. I have heard and performed each method many, many times during my training with excellent results each way. If there was a lot of work to do in the area, the coronal approach worked best in our hands since the access to the area is better. I know that it sounds horrific but so do most surgical procedures. Go with the surgeon with the most experience and let him/her decide the best method of secondary repair.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

Thank you for your response to my first question. We are aware of the second type of surgery to re-break the bone and put in a plate and screws to correct it, however, out of the two doctors consulted, they both had very different methods. One was to completely pull the face off making a half moon incision in the skull, from ear to ear, to gain direct access to the bone. The second was to make three incisions, going in through the mouth, under the eye and in the hairline to gain access to the bone. At this point, there are no scars from the original accident (except for the one from the original surgery in the hairline) and we're worried either one of the surgeries above would cause permanent scarring. That's why I was thinking an implant would be less traumatic. The second concern is that the jaw muscle has not completely recovered from being "stabbed" by the bone when it was initially broken. My brother has limited movement of his jaw and even though he's tried to "work out" the scar tissue, it doesn't seem to be improving toward 100%. After reviewing new x-rays 2 months after the surgery, the bone is still in somewhat of a "v" position. The doctor said he improved it over 80%. We give it 20% at best by look of the CT scans. Could it still be pressing on the muscles below and causing pain and immobility?

Answer:

The strongest muscles of the jaw insert on the zygoma and this is what is causing your pain. Also, the temporalis muscle, another strong jaw elevator passes under the arch and this may also be altered due to the fracture. The coronal approach (large incision through an incision in the hair) is usually the best for secondary revision and the scar, although present is within the hair and usually very thin. The second approach with the other two incisions is quite standard as well and may be necessary to obtain good fixation. The scars in the mouth and under the eye are really very minimal. Hope this helps.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

I am a 31yo male with pectus carinatum. I have been to two thoracic surgeons for evaluation. One recommended a surgery that would leave a "V" shaped scar on my chest that follows my inferior rib cage; and the expected hospital stay would be 4 days. The 2nd doc said I would have a short vertical scar over my sternum, with a 1 day hospital stay. Neither one does many of these surgeries (2-4 per year). Both recommended removing my xiphoid process, and the extra cartilage around the xiphoid. 1. Is one procedure better than the other? 2. Would a plastic surgeon have more experience in repairing pectus carinatum?

Answer:

Dear Mike, Both plastic and thoracic surgeons routinely perform this procedure but the number of cases nation-wide is not huge. I would suggest that you visit with the plastic and thoracic surgical departments in a large tertiary center such as the Mayo Clinic, Cleveland Clinic, etc. to find those with the most experience. Also, pediatric specialists may have slightly more experience since the severe cases are often done at earlier ages. It sounds as though the second procedure is placement of an implant. This is an easier method but will not help if you have any functional problems with breathing, your heart, etc. There are also problems of extrusion, infection, etc. with using foreign materials. The first procedure sound like one where your own bone is being altered to reshape your chest. I personally think that this is always a better way of going for all but the smallest of defects. Hope this helps.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

Hello: After 3 children ages 19, 14 & 5, I saved up for and decided to have a "breast lift" this was 3 years ago. I am left with much scarring, uneven areola sizes and one breast higher than the other. Is there anything that could be done to remedy this? I expressed my concerns early on with the plastic surgeon who said that things would become more "normal" with time. Sometimes I feel like this is my punishment for my vanity. Thank you for your time, Shelly

Answer:

I have performed revision breast lifts. Do not panic. I would need to examine you to see what needs to be done. Do not dispair.

Question:

Hi, On Dec. 29, 1997 I was attacked by a Lab/Chow mixed dog. The animal bit a large whole on the left side of my face, under my cheek. I recieved plastic surgery which involved 30 stitches on the surface and 10 dissolving stitches on the inside of my face. I was left with a scar. It could of been a lot worse than what it is, but I am very insecure about it. I try to do everything in my power so people do not see the scar. I always wear my hair down, I try to cover it with my hand, etc... My question is I would like to know if there is anything (laser or plastic surgery)that can be done to improve the appearance of the scar? My doctor told me that he could cut open the scar again and I would have to go through the same healing process as I did before, but I don't think I could go through it again. Please HELP ME. Thankyou

Answer:

Sorry to hear about your accident. Without seeing you, I can't give you specific advice about how your scar can be improved. Scar revision usually involves rearranging the skin to make the scar lines fall in less noticeable planes, or recutting portions of the scar so that the texture of the scar is better. Laser is not usually useful for this. Nothing will make a scar disappear; we can only try to make it less obvious. While it is true that if the scar is revised, you will go through a wound healing process again, that process should be less of an ordeal with revision. In dog bites these is a lot of crushing and tearing of tissue which is much more traumatic than scalpel incisions. You migh consider consulting a couple of plastic surgeons about what might be done for you specifically. Another thing to remember is that people are not as concerned about your appearance as you are, especially if you do not call attention to it. Good luck Carmen Paradis M.D.

Next Step

• Learn about Scar Revision / Scar Repair in the Articles Section
• Ready for a consultation? See qualified Facial Plastic Surgery doctors in your area

Browse All Questions & Answers

Example searches: lasik costs, tummy tuck recovery

Search: