Scar revision - Only doing part of scar

[BigBill1234]

If only part of my scar has stretched, is it better do only revise that part rather than the whole scar if only part has stretched? Does this leave less tension on the scar as it is not as long?

[stamos]

Yes it would be better to revise part of the scar (lets say on the left). Then your doc can take some grafts from the right side, if you want.

[Bill - Seemiller]

BigBill,

 

I agree with stamos. If only a portion of your scar is problematic, it's probably better to focus on fixing that section than removing the entire scar. However, if you're also trying to obtain more grafts for transplanting, removing a longer strip will be required.

 

Since there are varying philosophies and techniques on scar repair, I recommend speaking to a few leading physicians about your concerns and see what they recommend for you. To see a list of physicians we recommend, click here.

 

Best wishes,

 

Bill Seemiller

[Louise]

Hi BigBill1234,

 

That's a really great question. It is possible to revise a section of a scar that has "stretched" rather than revising the entire scar. It would really depend on the scar's location, how long and wide the area in question was and how flexible your scalp was. Is the area raised? Do you have any photos?

 

There are different ways of fixing a stretched scar, depending upon the problem. If your donor was closed using a single layer closure, perhaps you may benefit from a trichophytic, double layer closure. Perhaps, excising the area would correct the problem or you may have grafts added to the area (FUE from the other side).

 

Have you spoken with your surgeon yet? Most physicians will revise scars/offer to revise scars that patients are not happy with. I will speak with Dr Simmons and ask if he could elaborate a bit more.

 

Hope this helps.

[Cam Simmons MD ABHRS]

BigBill1234

 

Louise, Stamos, and Bill have given good answers.

 

If your only concern is the scar, I would usually only revise areas of the scar that have stretched and would leave the good areas alone.

 

The tension on the closure has more to do with the width of the strip than the length. Every scar revision is unique but if the VSL (vertical scalp laxity) is greater than the width of the scar there is a good chance that scar revision would be successful. If it isn't you would need to consider serial partial scar revisions and/or transplanting grafts into the scar.

[BigBill1234]

It is slightly raised... is that good or bad?

[Cam Simmons MD ABHRS]

BigBill1234

 

Stretched scars are usually not raised. The scar may be wider and slightly raised for other technical or healing reasons.

 

Determining why your scar is wider and doing a physical examination of your scar and scalp can help determine how best to fix it.

 

In general the height of the scar is less important than the scar width and the flexibility of the scalp near the scar.

[Blake Bloxham]

Dr. Simmons,

 

Thank you for your insightful contributions in this thread.

[Dr. William Lindsey]

Probably nearly 2 years ago I posted a black guy who'd had a bad scar at a chain operation who wanted a scar revision. He was fairly uptight about a big cut again, so we did half, and about 3 months later did a second procedure on the other side. While he did fantastic, he yet again came back for a small FUE, some of which were placed along the revised scar.

 

People with bad scars have them because of:

 

1. bad luck

2. bad genes--they and their family just scars worse than most despite great sewing...

3. poor closure

4. a combination.

 

SO, if someone is a bad scarrer, its certainly reasonable to do part of the scar initially and see how things turn out. Less of a procedure, less money, and less risk...as its conceivable that a scar revision can turn out worse than before. But fortunately not likely.

 

Dr. Lindsey McLean VA