Scar revisions

Patient Information sheet

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Scar revisions

Scar revision is a surgical procedure that corrects surface irregularities, contour deformities and the placement of scars in a better position for settling.
In the face it is mostly about getting them into the lines of facial expression in the limbs it is often about getting them into flexure lines and releasing
tightness although this is sometimes related to the face as well.
Scars cannot be removed only improved by manouevre. However there is always a scar.
Scarless healing is the holy grail of research efforts that centre around a hormone called transforming growth factor. After surgery treatments are important in getting them to settle.
Skin taping, silicone creams and occasionally pressure garments are all used.
A new scar forms at the site of surgery and goes through the same cycle you will be familiar with after your accident or operation in which they go red tight and obvious for a few months slowly settling towards a year. So much improvement occurs with time. We always leave scars for at least a year to see what is really going to be needed which is often less than was first apparent.
In children and young people scars remain red for longer than a year as there is still circulation growth hormone that influence the scar cycle.
This is a particular problem during adolescence as young people are painfully self conscious and expect the most from their operation.

 

Pictures below show the use of a Z-plasty method to break a scar into better direction and to reduce tension and pulling of the mouth. Excision and narrowing a scar on the forehead.

The result after one year - there are still scar marks seen but somewhat improved with no distortions. Breaking the scar into sections renders it less visible.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 A Z-plasty on a finger contracture release.

 

 

 

 

 

 

 

 

 

 

 

COSTS
Are often covered by ACC or insurance. This will be worked out before any operation. If pressure garments are required these will be made and fitted prior to operation. If it is not covered by ACC then discuss this with the surgeon to see what alternatives there are. Insurance companies will pay but there needs to a lot of correspondence and a pre approval process.

COSTS NOT COVERED BY ACC
ACC may or may not pay the for the cost of pressure garments. They do not always cover the cost of taping or the creams used.
Glyco pads are often prescribed and are imported from the United States and passed through at wholesale.
Silicone cream is sometimes prescribed and again is imported specially.
Dermodrate is sometimes prescribed and is available by a dispensing chemist.

FOLLOW UP
Follow up will take place for at least a year in most cases and may continue at yearly intervals in the case of a child still growing as scars do not grow as readily as normal tissue and may need further attention.

OPERATION STAGES
ACC accept that treatment may not be accomplished in one sitting. Many scars need more than one stage as blood supply considerations limit what may be achieved at one time. It is safe to assume that more than one stage is likely. Most procedures can be done as a day stay and smaller procedures are quicker to recover from.

RECOVERY
Recovery is quite quick after these procedures. It is necessary to rest for about 10 days to speed healing.
Specific instructions will be given by your surgeon for skin taping or skin applications.
Plasters and splints may be required. Physiotherapy may be required after operation on hands or limbs.

YOUR RESPONSIBILITIES
• To reveal all medications, conditions, history, allergies, recreational drug use AND SMOKING STATUS.
• To understand all aspects of the information discussed at consultation and all written information given and to seek clarification if needed.
• To understand that you are entering a process where your surgeon is dedicated to the best possible outcome. This requires engaging in the complexities of biology, healing and individual differences
• That additional stages or further surgeries are occasionally required and that the surgeons best efforts are the basis of the charges. Further surgeries will incur additional charges in pursuit of a particular result.
• To understand that the initial consultation is charged for but all subsequent pre operative consultations pertaining to this surgery are at no charge.
• To understand and accept the above conditions