Unsightly scars can be caused by trauma, surgical procedures, or inflammatory disorders like acne. Correction of some scars require surgical scar revision. Most revisions can be easily performed with significant improvement or even elimination of scars.
Excision and closure of a widened scars with meticulous resuturing can be successful because the skin has stretched since the original operation. Skin closure occurs under much less tension. Less tension of wound closure results in less spreading of the scar. Excision and closure can also correct depressed scars with a groove. The scar is made flat by repairing the deep tissues below the skin.
Re-orienting of the scar direction may be necessary if the scar does not follow the aesthetic lines of the face, also known as the relaxed skin tension lines (RSTL). Normal wrinkles follow these lines. This correction of scar direction is performed with a Z-plasty. Occasionally, multiple Z-plasties are needed.
When the skin surrounding the scar is smooth and without wrinkles, geometric broken line scar revision is done. This technique changes a linear scar into an irregular scar. The effect is similar to the smudge tool of Photoshop. The starkly linear scar is made fuzzy and less conspicuous.
In some cases, replacement of scar tissue with nearby normal skin is required when the scar tissue is too extensive to simply excise or re-orient. This is done with a skin flap reconstruction.
Most often, a combination of above procedures is required.