Cosmetic Surgery of the Body

Scar Revisions

Leesburg - Northern Virginia - Loudoun

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Scar revision procedures may be beneficial if you feel that your scar does not appear as ideal as you think that it should be.  It is, however, important to understand that a visible scar will always be present after any and all cuts, incisions, or other causes of a break in the skin.

It is the role of a scar revision and proper scar care to minimize the appearance of the scar as much as possible.  

  • Excisional scar revision
  • Laser scar revision
  • Steroid injections

A scar is the result of any breaks in the skin whether from surgical incisions, traumatic lacerations or even traumatic abrasions.  The resulting scar is a result of your bodies reaction to close up the wound.  An ideal scar is flat, white, and blends into the surrounding skin.  A bad scar may result if the conditions for wound healing are not ideal.  The scar may become raised, red, thick, itchy, and even painful.

The reasons behind the development of a bad scar can include excessive tension on the closure of the wound, the location of the wound, external irritants, trauma to surrounding tissue, and genetics.  

Scar revision options including removing the bad scar and starting over while optimizing the conditions for healing, laser treatments, and steroid injections.

 
  • Reduce the tension on the wound closure
  • Keep the wound moist with ointments such as aquaphor other medical gel
  • Apply continuous and gentle pressure on the wound such as with a silicone sheet or steristrip
  • Keep the wound away from UV exposure as much as possible

 

 
  • A bad scar is not a keloid
  • A keloid is a bad scar

A keloid is actually an inheritable medical condition characterized by the hyper-proliferation of fibroblasts which are one of the main cells that help heal up a wound.  The result is too much of a good thing; the scar becomes raised and irritated.  This is a condition that is common in certain ethnicities including persons of color. Keloids are treated very differently from hypertrophic scars.  Because of the genetic component, keloid scars tend to return despite best efforts at repair.


This is in contrast to a hypertrophic scar which is what most people see as a “bad scar”. Hypertrophic or bad scars are seen as raised or wide.  Treatment options will depend on the exact nature, but may include surgical revision ( cutting it out and starting over but optimizing the conditions for its healing ), Profractionated laser treatment, or steroid injections
 
  • 1-3 months:  the scar becomes progressively red and raised
  • 3-12 months:  the scar begins to flatten
  • 12-18 months:  the scar begins to whiten

It will take about a full year for your scar to heal to the best of its ability.  The repaired wound will actually look worse before it begins to look better.  

Wound healing begins with the proliferation of cellular fibroblasts clean the wound while producing new collagen.  During this proliferative phase, your wound becomes red and raised.  Over-proliferation of your fibroblasts can result in a scar that is overly red and raised.

After a few months, scar wound will enter a modulation phase in which the new collagen will begin to remold.  The thickness of the scar will soften and the redness of the scar will begin to lighten.

After about 12 to 18 months, the scar should become flat and white.

You are a candidate for a scar revision if your scar is raised or wide.

  • Keep the wound moist with scar ointment ( too moist is not good either )
  • Keep gentle continuous pressure with silicone sheeting or steristrips
  • Avoid direct sun exposure
  • Avoid excessive tension 
  • Profractionated laser
  • Steroid injections

The surgical goal for any scar revision is obviously to produce a better scar than the one that you already have.  the goal should be a scar that is thin, white, and blends into the surrounding skin.  There is usually the presumption that there was some factor in your original treatment or healing process that was not ideal.  Some of these factors include:

The person closing the wound the first time was not a plastic surgeon

  • The person closing did not attempt to decrease the tension by using certain techniques such as undermining the surrounding tissue, using deep and layered sutures, or avoiding placement of surgical scars on areas of the body with high tension.
  • Emphasizing the application of constant moisture
  • Emphasizing the application of continuous gentle pressure
  • Apply aquaphor 3x per day for 1-2 weeks
  • Apply scar gel ( we like biocorneum ) beginning a 2 weeks for 3 months
  • Apply silicone sheet at night for 3 months 
  • Avoid direct sun exposure
  • Avoid local irritants directly to the healing wound
  • The scar will be become increasingly red and raised for up to 6 months
  • The scar will become flatter and lighter after 6 months for up to 18 months
  • Profractional Laser can be used to optimize the appearance of the scar
  • Steroid injections can sometimes be used to flatten hypertrophic or itchy scars
 

Recurrence of a raised, dark, or wide scar

Scar revision will depend on the nature and length of the scar or wound as well as the type of revision.

When done well, a scar revision will significantly enhance your physical appearance, so it is important to concentrate on having a skilled surgeon with years of training, like Dr. Chang, rather than a low price. To help make surgery affordable, Aesthetica Cosmetic Surgery & Laser Center will help you find low-interest financing.

Scar revision is viewed as a cosmetic procedure by most health insurance companies; they will therefore not cover the procedure.

Our office may provide payment plans to help spread the cost of surgeries that aren’t covered by insurance.

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Dr. Chang Featured in a Maagazine

Dr. Phillip Chang is a leading plastic surgeon in Loudoun County who specializes in surgical and nonsurgical cosmetic procedures for the breast, body, face, and skin. He is board certified in plastic surgery by the American Board of Plastic Surgery and is the founder of Aesthetica Cosmetic Surgery & Laser Center in Leesburg, VA. Dr. Chang is dedicated to providing high-quality service that concentrates on the unique needs and concerns of his patients. He believes combining attentive care and minimally invasive techniques is the best avenue for achieving beautiful, natural-looking results. Dr. Chang is thrilled to be serving the greater northwest area of Washington, D.C. with top cosmetic care that is dependable and trustworthy.

Interested in learning more about Dr. Chang? Click here.

We are based in Leesburg, VA. Located as part of the Lansdowne medical complex, you have access to our 24-7 state-of-the-art facility as well as access to Lansdowne hospital. We are based directly across the road from INOVA hospital. There is ample parking, elevators to bring you to our third floor offices, and welcoming staff to sign you in.

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All potential patients receive either a phone, virtual, or in-consultation for free.

During the consultation we will discuss your treatment wishes and expectations. This is the time to ask us lots of questions to really understand what is involved, what the costs will be, and what is expected of you. This is also a great time to get to know Dr. Chang.

Aesthetica has received numerous awards from the Loudoun County Chamber of Commerce, New Beauty, Best of Loudoun, Posh 7 Top Picks, and Dr. Chang is internationally known for his lectures and advances in precise surgical technique as demonstrated through his unique mini-facelift procedure.

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