Scar Revision Dallas
There are many types of scars: raised scars, linear scars, and atrophic scars (depressed scars). There are other sections that concern raised scars (like keloids) and atrophic scars (like acne scars). However, this section discusses only how to correct linear scars.
- The goal of a scar revision is to make a scar that is visible from a social distance much harder to see. The principal way that Dr. Lam corrects scars is via a geometric broken line repair (GBLR). This technique involves visually breaking up a straight line into multiple small zig zags of different shapes like triangles and squares. The human eye cannot perceive this irregular design compared with a straight line and so it serves to make the scar virtually undetectable from a social distance. Of course, there is still a line there: it should just only be truly visible from a close inspection. There are many other methods of scar revision like Z-plasty and W-plasty. However, Dr. Lam believes there is nothing better than a GBLR in most cases. A Z-plasty lengthens and reorients the scar, which can be helpful if the scar is contracted or misaligned. However, its regular design makes it more visible than a GBLR. At times, Dr. Lam may incorporate a Z-plasty to lengthen a contracted scar but would not want to lengthen most scars. A W-plasty is essentially a poor version of a GBLR. Its regular limbs are far easier to create for the surgeon but the result is that the scar is much more visible to an onlooker.
- Scar revision may require multiple visits like a mole removal (see mole removal) in order to ensure that the scar becomes less visible over time. Initially, the scar will be much more visible and will take time to heal and mature. Dr. Lam does not charge for these follow-up visits and encourages every patient to follow up as often as he requests, which can be between 2 to 10 visits over a year. Unlike mole removals, he does perform scar revisions for out-of-town patients but asks that every patient understand that multiple visits (based on one’s free schedule to return, as there is not strict timeline of visits) should be considered before scheduling a procedure with Dr. Lam.
Does Dr. Lam guarantee that my scar will look better?
There are no guarantees about any procedure. However, Dr. Lam believes with proper education about the realistic goals (stated above), the timeframe for recovery (several months to a year), and the need for multiple small office-based adjustments performed at no charge (dermabrasion, micro silicone, laser, scar dissolving injections) that almost all cases will be a vast improvement over what you currently have. In addition, Dr. Lam carefully selects patients in whom he believes will see improvement in his results. With all of that said, Dr. Lam also stands behind his work and believes that if he can improve the scar in any way that he will do so.
Besides breaking up the scar from a line into a geometric design, are there other aspects to making a scar less visible?
Yes. As mentioned above, sometimes a scar can be contracted and must be lengthened. He may perform a V-Y advancement or a Z-plasty to improve the scar length or reorient it. If it simply needs to be lengthened he may use a V-Y advancement and if it needs to be lengthened and reoriented he may use a Z-plasty, as an example. There may be associated contour deformities (the area is too high or too low) and he may need to adjust the contour to make it flush (or at least closer) to the surrounding skin. There may be persistent color changes that may need bleaching products or lasers. There may be associated depressions that may need filling. The line could be improved by migrating it over to the border of what is known as a facial subunit. A facial subunit describes areas of the face where there are natural lines along the borders and where our eye would naturally see a line. Moving a scar into one of these lines may be helpful to further camouflage the incision if doing so does not cause undue tension. Sometimes the scar is not linear but instead constitutes an area of diseased skin that needs to be removed. With Dr. Lam’s extensive experience with skin-cancer reconstruction, he is fully versed in managing this situation using rotational and transposition flaps to remove the diseased skin and to close the skin with minimal tension. These are more advanced concepts that need to be discussed with Dr. Lam if he sees there is a need for this type of surgical intervention. You can visit Dr. Lam’s extensive catalog of major skin-cancer reconstructions to see a gallery of his work. Warning that these may be construed as graphic images.)
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Call 1-888-866-3388 or email us to schedule your scar revision consultation. The details of your scar revision surgery (both the limitations and the benefits in your particular situation) will be explained to you during your consultation with Dr. Lam and his team.