The procedure will vary depending on the degree of alteration that needs to be done to address each specific scar. Factors that need to be taken into consideration would be the scar type, size, depth, pigmentation, texture, and location.
Typically, a combination of techniques are used to achieve the best possible outcome.
There are three ways to improve the appearance of a scar: (1) Topical treatment, (2) minimally invasive procedures involving fillers or resurfacing modalities such as laser, chemical peel, or dermabrasion and (3) surgical scar revision procedure.
Shallow or surface scars may be treated through topical treatments such as gels, external compression, and tapes. Topical treatments may also be used to help in the proper healing of surgical scar revision.
In the case of depressed scars, injectable dermal fillers can be used to raise the skin and improve the scar’s appearance. For raised scars such as keloids, steroidal-based compounds can be injected to reduce collagen formation, which can help reduce the size and improve the texture of the scar tissue.
Treatments that offer skin surface enhancements such as dermabrasion, chemical peels, laser skin resurfacing, or topical bleaching creams can be used to further improve the appearance of the scar. These treatments work by minimizing surface irregularities and pigmentation through the elimination of the top layers of the skin or by modifying the affected tissues.
In more severe cases, surgical treatments can be used for maximum effectivity. These will involve incisions and sutures There are a variety of advanced scar revision techniques for different types of scars, including layered closure, complex flap closure, and W-plasty or Z-plasty.
Tissue expansion or skin grafts may also be used in cases where there is not enough healthy tissue for the closure of scar excisions, such as with severe burn scars.