Scar reduction with excision. Surgical excision of scars When can a scar be excised

Scars, or colloquially scars, are almost every person for one reason or another. They are not only a cosmetic defect, but often cause many problems: they cause discomfort, pain, itching, they can ulcerate, become inflamed, deform a part of the body and restrict movement. Therefore, the removal of scars is an urgent problem.

A scar is formed when the skin is deeply damaged, when its complete anatomical restoration does not occur, and the defect is closed by growing fibrous tissue. The process of scar formation depends on the individual characteristics of the person.

In some people, even with significant damage, the scars become barely noticeable over time, while in others they are rough and dense. Modern possibilities of medicine allow you to remove various types of scars or significantly improve their appearance.

Shulepin Ivan Vladimirovich, traumatologist-orthopedist, highest qualification category

The total work experience is more than 25 years. In 1994 he graduated from the Moscow Institute of Medical and Social Rehabilitology, in 1997 he completed residency in the specialty "Traumatology and Orthopedics" at the Central Research Institute of Traumatology and Orthopedics named after I.I. N.N. Prifova.

Most scars, when fully developed, flatten and become skin-colored. The time during which the scar heals, or rather matures, is very variable. This process goes through several stages:

1. Initial, lasts 7-10 days from the moment of gluing the edges of the wound until a noticeable "young" scar appears. There is an increase in the synthesis of collagen fibers in the area of ​​the healing wound, its edges are edematous, compacted.
2. Scar formation stage, lasts 20-30 days, a soft edematous scar of bright pink or red color appears on the skin due to increased blood flow.
3. The process of "aging" of the scar, lasts from 1 to 3 months, the scar becomes strong and dense, redness disappears, but swelling persists.
4. Complete completion of scar formation, occurs from 4 months to a year, sometimes longer. Infiltration and edema disappear, the scar becomes pale, dense, with clear contours.

It is difficult to influence this physiological process, its course depends on age, body constitution, state of health, immunity. Therefore, in the choice of treatment for any scar, the stage of maturation it is at plays an important role.

Types of scars and scars by origin

Scarring occurs as a result of a deep defect in the skin when it is damaged or destroyed by an inflammatory process. Traumatic nature have scars after cuts, gunshot wounds, burns, surgical interventions. Inflammatory origin have scars from acne and boils, from smallpox, from chickenpox, other skin and infectious diseases. All of them have their own characteristics of formation and appearance.

Scars from cuts

Most often, scars from cuts occur on the hands when injured with a knife, blade, glass in everyday life and at work, on the legs in the event of a blow to a sharp object or when they step on glass fragments. On the hands, most often cut wounds occur on the fingers, on the palmar surface of the hand, on the wrist.

After cut wounds, scars, as a rule, form thin and inconspicuous, with the exception of deep lesions with tissue defects.

After the wounds

A gunshot wound is always accompanied by deep tissue damage around the bullet channel, and therefore the scars are formed more coarse. Often they are retracted in the form of a funnel, and after an extensive tissue defect, a disfiguring scar is formed in their place. Much depends on the surgical treatment of a bullet wound, plastic surgery is often required.

From burns

Body burns can be thermal, chemical, radiation, solar. The dual effect of the damaging factor - temperature, radiation, chemical substance - contributes to the fact that the scars formed from burns mature longer and are often rough, deforming, painful, prone to the formation of keloid. And those that are located in the area of ​​\u200b\u200bthe joints lead to a limitation of their mobility, the formation of contractures.

After operations

Among all types of scars, the least noticeable are those that form after surgery. Most often, such scars are localized on the abdomen - after appendicitis surgery, removal of hernias, in women it is not uncommon for a caesarean section. On the chest, scars occur after operations on the heart and lungs, the esophagus, on the neck - after removal or resection of the thyroid gland.
A feature of postoperative scars is their faster maturation, low visibility. This is due to the special rules of incisions, when the course of collagen fibers of the skin (Langer lines) in various parts of the body is observed.
The skill of the surgeon and the type of technology used also matter. For example, the use of a laser scalpel that performs ultrafine tissue dissection, the use of biological glue instead of sutures, and special wound closure devices. All these innovations contribute to the healing of postoperative wounds without the formation of noticeable scars.

After mole removal

After surgical removal of a mole, the formation of a dense scar is characteristic for the reason that a wide excision of the formation is performed over the entire thickness of the skin. Today, the "gold standard" of such an operation is laser removal, after which subtle traces remain.

Types of scars by structure

According to the structure and appearance, the formed scars are divided into 4 categories:

• normotrophic;
• atrophic;
• hypertrophic;
• keloid.

Normotrophic scars are the least noticeable on the skin, do not disturb its relief and look like a light strip or spot. They are formed after shallow incised wounds and surgical interventions.

Atrophic scars have a thin, soft, concave surface, form a depression, retraction on the skin. They are characteristic of smallpox, boils, acne.

Hypertrophic scars - rough and dense, rise above the level of the skin, often formed after the healing of purulent wounds, burns.

The name of keloid scars comes from the Greek kele - tumor and eidos - appearance. These are tumor-like scars, which are formed not only at the site of a healed wound, but also grow beyond it. They have a cartilaginous density, often purple in color due to squeezing of the vessels, the surface may be cracked, ulcerated, causing itching, pain, burning. The favorite place of their formation is the region of the neck, the back of the head, the auricle, the chest, the most common cause of burns and the individual characteristics of the tissues.

Features of keloid scars. Who is inclined to their education more than others

Treatment and removal of scars

The desire to reduce the scar is quite natural for its "owner", especially if it is located on an open area of ​​\u200b\u200bthe body. To avoid a noticeable scar, many try a variety of remedies at home - from those sold in pharmacies, from traditional medicine.

Treatment can be effective only with an individual approach, taking into account the nature and location of the scar, the characteristics of the body and the age of the patient.

Most often, it is complex, including medications, external agents, physiotherapy, hardware or surgical removal.

Medical treatment

As drugs that reduce the formation of hyaluronic acid and soften scars, apply enzyme preparations- lidase, hyaluronidase, longidase in injections. Also appointed steroid hormones- kenalog, diprospan. They are prescribed only by a doctor and are used under his supervision.

The immune system plays an important role in the formation of keloids, therefore, after a laboratory examination, immunocorrection is prescribed to reduce the excessive reaction of the body.

Ointments

The choice of ointments that are recommended for scars is very large. Ointments have proven themselves well - contractubex, mederma, kelofibrase, clearvin, fermencol, new creams and gels containing polypeptides, silicone and even stem cells - Scar Zone cream, stickers and gels Cica Care, Scar Reducing and many other means. It is necessary to smear the scars several times a day, and the choice of remedy should be agreed with the doctor.

Physiotherapy

Among electroprocedures, iontophoresis with enzymes - lidase, ronidase, collagenase, ultrasound (phonophoresis) with corticosteroids or absorbable anti-scar ointments is prescribed. Good effect gives a new method shockwave therapy(UHT), which gradually mechanically destroys the scar. Physiotherapy gives a good effect when the scar hurts and thickens after an operation, a cut wound, a burn, and also when it itches and becomes inflamed.

Hardware Methods

Removal by physical impact is used for old scars, as well as when treatment with ointments and physiotherapy has not worked. These include cryotherapy, laser therapy, radiation therapy.

Cryotherapy

The method of treatment with ultra-low temperatures using liquid nitrogen. Nitrogen is applied with a special apparatus for 10-15 seconds, causing hypothermia and slight frostbite in the scar area. There is a death of its tissues and inhibition of the formation of collagen fibers.

Laser therapy

By exposure to an argon laser, you can quickly and effectively get rid of scars, the procedure is called fractional photothermolysis. There is a warming up and death of coarse collagen cells and stimulation of new, healthy fibers. Carry out from 1 to 3 procedures in combination with steroid hormones.

The laser allows you to remove hypertrophy and keloid tissue, as well as stimulate tissue repair during atrophic changes.

X-ray therapy

In severe cases, X-ray therapy is used for a severe form of keloid growth, which is regarded as a tumor. Usually, several sessions are prescribed on an individual basis with special "light" Bucca rays, which affect only the skin layer.

How to cover up a scar

If the scar is not disfiguring, does not cause any particular complaints, and if it is not possible to consult a specialist, the defect can be made less noticeable in various ways:

• with the help of decorative cosmetics - on the face and neck;
• hide scars under clothes, bracelets, plaster;
• disguise under tattoos, the fashion for which is very stable.

Important: You can not apply a tattoo to areas of cicatricial hypertrophy and keloid growths, this can lead to even more compaction, inflammation.

It is not always possible to completely get rid of scarring on the skin, but you can make them less noticeable in various ways at a professional level. In order not to leave a rough scar after the operation or injury, it is better to take measures in advance immediately after the wound has healed, using ointments and procedures prescribed by the doctor.

What to consider so that you are not deceived in the treatment of scars

Proper and timely excision of scars can make life as easy as possible for every person, especially for the fair sex, for whom appearance plays such an important role. Believe me, there are just a huge number of different methods on how to reduce the appearance of scar tissue or eliminate it completely. Scar removal is the safest and most effective method that has already helped many people achieve a beautiful appearance. In this article, we will pay attention to it.

Scar excision: main benefits

This method is so popular because it has a huge number of advantages. That is why experts recommend it to almost all patients. Pay attention to the following advantages of the excision method:

After the procedure, you will not need hospitalization, so you can safely go home;

Excision of scars can reduce the width of unwanted connective tissue or eliminate it completely;

All inhomogeneous particles will be removed from the scar, and the tissue will become more prominent;

The procedure is painless;

If desired, the scars can be shifted to hidden areas.

Indications for use

A procedure called scar excision, the photos of which are simply amazing in their effectiveness, is very often recommended by doctors to many groups of patients. Pay attention to the cases in which this operation will show the best results:

With its help, you can eliminate traces after household injuries, burns, as well as after firearms and edged weapons.

When a large surface of the skin is damaged. At the same time, scars can be not only very large, but also small, but in large numbers, so their presence is very noticeable on the skin.

This procedure is also indicated if you have had a cosmetic suture after the operation.

Also, doctors may prescribe this operation if you already have chronic hypertrophic or keloid scars.

How is the preparation for the operation going?

Surgical excision of scars can be performed only if the doctor has determined that this operation will really have a positive effect. According to the experts themselves, it is very difficult to completely remove scars, but it is quite possible to make them almost invisible. This operation can not be performed immediately after you notice the scar. It must fully mature, so you will have to wait from a few months to two years. Each case has an individual character. If you start working with scar tissue at an earlier date, then this may be fraught with relapse.

So, before carrying out the procedure, you will have to perform the following steps:

Talk to your anesthetist about whether anesthesia is right for you.

Start eating right. Eliminate all unhealthy foods from your diet, and include as much milk, vegetables, meat and fruits as possible.

Avoid alcoholic beverages, as well as some drugs that will impair the ability of blood to clot. First of all, Aspirin should be attributed here.

Be sure to tell your doctor if you have any allergic reactions to any foods or medications.

A couple of days before the operation, try to ensure that various cosmetics (especially those containing alcohol) do not get on your scar.

Be sure to get tested for sexually transmitted diseases, as well as determine the blood type.

All the stages of preparation described are mandatory, so it’s better not to joke with your health. Excision of scars on the face and body, of course, is a cosmetic procedure, but still it hides its dangers. Therefore, diligently follow all the recommendations that the specialist will give you.

How is the procedure carried out

This operation is always performed under anesthesia. After it works, the specialist will excise each scar with a laser or scalpel. Now the edges of the connective tissue are lifted and connected with a suture that is made on the inside of the skin. Usually the procedure is done very quickly. The whole process takes half an hour to an hour.

Recovery period

Scar removal (before and after results are amazing) is a very effective procedure. However, do not think that the very next day after the operation you will see excellent results. Unfortunately not, you will have a recovery period ahead of you.

So, as soon as the operation is over, a bandage will be applied to the affected area that can stop the bleeding. You can take it off the next day. Protect the skin from any mechanical damage, as well as from sunlight. The stitches are usually removed after a week. After that, the skin will need maximum hydration, so do not ignore the advice of doctors and purchase special moisturizing formulations.

Usually the postoperative period lasts about three to four weeks, so at this time it is better for you to stop playing sports at all. The maximum that is allowed is walking. But the final results after the procedure can be seen only six months after the operation. Sometimes the doctor also prescribes additional procedures that help speed up the effect and improve the result. As you understand, it is strictly forbidden to engage in amateur performances in this case.

Are there any contraindications

Doctors strongly do not recommend cosmetic excision of scars for women during menstruation. It is also better to refuse the operation for people suffering from diseases of the respiratory and cardiovascular systems. It is better not to have surgery for persons with clearly noticed mental disorders.

Does this procedure have any disadvantages?

Any procedure, including excision of scars (you can read the reviews below), has its drawbacks. Therefore, before the operation, be sure to familiarize yourself with them, and only after that draw conclusions whether this method of scar removal is suitable for you.

One of the biggest drawbacks is the discrepancy between results and expectations. The specialist is obliged to warn his client that, most likely, the scar will still be slightly noticeable. But many people simply ignore this information.

This method is quite traumatic, while prolonged neuralgia may occur, and bruises and bleeding may also appear.

Usually, a new one, albeit less noticeable, appears in place of the old scar. And over time, it will have to be sanded a little so that the skin takes on a neater look.

A surgical or cosmetic method that allows you to smooth out or make less noticeable scars and scars that have arisen as a result of operations, burns, incisions, tears, and skin diseases. Such defects are formed due to the replacement of elastin fibers by fibrous tissue. It is impossible to get rid of these defects completely, but it is possible to significantly reduce their severity. As a result, scars and scars become almost invisible.

Correction of scars and scars in the clinic "Kivach"

In the Kivach clinic, the removal of scars and scars is carried out by two methods:

• surgical excision;
• laser removal.

The method is chosen depending on the nature of the scar, its size and severity.

The clinic's plastic surgeons recommend undergoing the "Cleansing the body" program before the operation. This normalizes the physiological balance and minimizes the possible risks of complications during the operation and during the recovery period.

After surgery, patients are offered comprehensive programs to accelerate the healing of postoperative wounds and reduce swelling. These programs allow to reduce the rehabilitation period by an average of 2 times.

Check out our programs

Indications

• Post-acne (sequelae of acne).
• Normotrophic, atrophic, hypertrophic, keloid scars.
• Postoperative, post-burn and post-traumatic scars and scars.
• Stretch marks (striae).
• Uneven excessive pigmentation (melasma).

results

• Elimination of post-acne. Smooth, even, well-groomed skin.
• Maximum scar coverage. Scars become almost invisible and imperceptible to the touch.
• Reducing the size and visibility of stretch marks.
• Alignment of the relief and shade of the skin area relative to the surrounding tissues.

About the operation

Operation duration: depending on the complexity and size of the scar, varies from 20 to 40 minutes. The duration may be extended for medical reasons.

The duration of the rehabilitation period: from several days to 2 weeks.

Effect: becomes noticeable after 1-2 weeks; the final can be assessed after 3-6 months.

Where applicable

Scar removal technique

The method of correction of scars and scars is selected individually, depending on their type, location and characteristics.

Surgical excision is preceded by a number of laboratory and instrumental studies.

Download our checklist to find out what tests you need to take.

Download

With laser correction, research is not required.

Laser removal of scars and scars (polishing)

The method is designed for more "young" scars and scars that do not affect the deeper layers of the skin. The laser correction procedure, as a rule, does not require prior anesthesia. In case of treatment of the face or high sensitivity of the patient, local or application anesthesia is used.

The treatment is carried out with a non-contact laser beam, which is directed to the scar tissue with the help of a tip. Under the action of radiation, the surface layers of scar tissue evaporate. The laser acts pointwise, so neighboring areas of the skin are not affected.

After 3-5 days after the operation, a dry crust will appear at the treatment site, which will fall off by itself in 7-14 days. During this period, direct sunlight should be avoided, the site of exposure should be treated with a drug that has a healing effect.

Several sessions may be needed to achieve the desired effect.

The older and deeper the scar, the more difficult it is to remove. Surgical excision is used for large scars and scars that "hook" the deep layers of the skin. This is the most effective way to get rid of such defects.

The operation is performed under local or general anesthesia, depending on the size of the scar, its age and depth. Using a scalpel, the surgeon cuts out the scar, and neatly sews its edges together.

After tissue healing, an almost imperceptible thin pale line remains at the site of the scar or scar. The final effect can be assessed after 6 months.

During the consultation, the plastic surgeon of the clinic will listen to your wishes, conduct an examination, prescribe additional examinations if necessary, and offer the best correction methods for you.

Contraindications

• Diabetes mellitus in the stage of decompensation.
• Blood diseases, clotting disorders.
• Epilepsy.
• Diseases in the zone of planned impact - dermatitis, eczema, psoriasis, herpes, etc.
• Exacerbation of chronic diseases, acute inflammatory and infectious processes.
• The use of retinoids and photosensitizing drugs that increase susceptibility to ultraviolet light.
• Recent chemical or other peeling.
• Pregnancy, lactation.

Question answer

1. When can the result be evaluated?

1. The result of correction of scars or scars with a laser becomes noticeable after the first procedure. For small scars, 1 session is enough. In some cases, a course may be required - up to 10 sessions. It all depends on the depth, area and prescription of the scar.

2. With regard to surgical excision, the result can be assessed 3-6 months after the operation. That is how much time it will take to form a new, even, neat seam.

2. What result to expect?
3. • The scars are reduced in size, become light and almost invisible.
   • The process of skin regeneration starts.
   • The skin relief is corrected.
   • Foreign particles are removed.
   • With the help of excision, the scar can be moved to a zone hidden from the eyes.

   Unfortunately, it will not be possible to completely get rid of the scar, but instead of a rough scar, a barely noticeable, even and light seam will remain.

4. Is the operation safe?

The operation is relatively safe. Laser removal can be performed without anesthesia. Surgical excision, depending on the characteristics of the scar, is performed under local or general anesthesia (anesthesia).

5. How to prepare for the operation?

The scar must be formed. For this, it is necessary that after its occurrence, from 6 months to 1 year has passed.

No special preparation is needed for laser scar correction; only a doctor's examination.

In the case of surgical excision, the patient undergoes an examination and passes the tests prescribed by the doctor.

• 14 days before the operation, it is advisable to give up smoking and alcohol.
• Before the operation - a hygienic shower.
6. What is the duration of the rehabilitation period?

7. The recovery period is not long. With the surgical method, a cosmetic suture is applied, which dissolves after 7-10 days. With the laser method, a crust forms at the treatment site, which will fall off on its own. The formation of a new skin in the affected area lasts 2-3 months, depending on the individual characteristics of the organism.

   • Within 3-4 days after the operation - do not allow water to enter (if the procedure was performed using a laser, this restriction can be ignored).
   • Within 7 days after the operation - do not use cosmetics and care products in the affected area.
   • For 2-3 weeks after surgery, avoid UV rays.

   The patients of the clinic are offered comprehensive programs of restorative procedures that accelerate tissue regeneration. These procedures can reduce the rehabilitation period by an average of 2 times.

8. Are complications possible?

When removing scars and scars, complications rarely develop. Swelling, redness of the skin, crusting are possible. All unpleasant symptoms disappear on their own after 7-10 days. To minimize the risk of complications, it is recommended to use the Body Cleansing program before the operation.

9. What guarantees the success of the operation?
10. • Certified plastic surgeons.
    • Compliance with medical standards.
    • Passing the program "Cleansing the body" before the operation minimizes the risk of complications.
    • The passage of any of the comprehensive programs after the operation will shorten the rehabilitation period.

The cost of the operation does not include the cost of anesthesia

Correction of scars and scars

Excision of scars on the face is represented by plastic surgery measures aimed at eliminating a cosmetic defect using various techniques, the choice of which depends on its features and location. The scar itself is a dense connective formation formed in the process of tissue regeneration after:

• surgical intervention;
• damage to the skin;
• inflammatory processes;
• ulcerative lesions.

It mainly consists of a fibrillar protein that forms the basis of the connective tissue of the human body and is known as collagen. Visually, it differs from the tissues that it replaces, and is not as functional. They resort to removing scars and scars on the face and body due to the fact that they stand out against the background of healthy skin and spoil the appearance, often being a source of complexes and psychological problems.

Excision of scars (keloid, atrophic) - on the face (1 cm) - 14,000 rubles.

Excision of scars (keloid, atrophic) - on the body (1 cm) - 8,000 rubles.

Included in the price:

surgery, consultation with an anesthesiologist, anesthesia/narcosis, hospital stay with meals, dressings, postoperative follow-up by the attending physician for a month.

1-3 days in hospital

Removal of scars on the face and body in Moscow

Modern plastic surgery offers effective techniques to remove scars on the body and face. You can order services of this direction in the department of plastic surgery of CELT.

Excision is a surgical method of scar correction, with a very careful comparison of the edges of the scar, using a special low-traumatic suture material and applying cosmetic intradermal sutures. Not too wide scars with moving edges are subject to excision. As a result of the operation, the initial dimensions of the scar become smaller, the surface does not stand out above the level of the skin.

Preparing for the operation

Surgical excision allows:

• practically remove the scar, or make it smaller;
• move the scar to a hidden place;
• correct skin texture.

Modern surgical methods for excising scars are quite radical methods, they are usually used in extreme cases. For example, when the scars are too large and obvious, or if other therapy does not help.

To achieve the desired effect of scar plastic surgery, without side effects and complications, some preparatory actions are required. The sequence of actions of the patient, which is most likely to lead to a successful outcome:

1. Consultation with a medical specialist. This is necessary because only a doctor knows and will tell you about the possible risks and complications. The patient should be aware that the operation will not remove the scar 100%, it can be made inconspicuous or moved to another place on the body, the patient also needs to understand that after the operation it will be necessary, and this can be difficult.
2. Before the operation, you need to pass the necessary tests and undergo an examination. Also, you need to follow a diet and limit alcohol consumption. It is necessary to notify the doctor about whether any drugs are currently being taken, whether the patient has an allergy to anything.

Scar plastic surgery is not a simple matter, if all the preparatory requirements are met, everything is agreed with the doctor, only then can we expect the proper effect after the operation. Otherwise, the operation may fail.

Surgery

At the moment, there are many ways of surgical excision of scars. When choosing a specific method, the specialist pays attention to the density, size, type of scars. What is important is the condition of the skin surrounding the scar, and the position of the scar relative to other landmarks of the human body.

Much attention is paid to complex scars that have arisen as a result of surgical operations, after serious burns, deep injuries. What are the features of the operation:

1. Small scars, slightly protruding above the level of the skin, are excised with a scalpel or blade parallel to the skin. It is very important here not to cut too much, so that the raised part of the scar is marked. Uneven boundaries between the removed scar and healthy skin are corrected with electrosurgical instruments. The healing of such a wound occurs by secondary intention, that is, it is not sewn up.
2. Also, a common way to excise scars is a spindle-shaped or elliptical excision. It is generally used to eliminate scars that are located across the natural lines of a person's skin. Across the scar, so that the new one coincides with the natural line, an incision is made, the edges are slightly excised and finished with suturing. A temporary suture is applied if the original scar was long enough, and then the operation requires several such approaches to completely remove the old scar. The result is a new scar, cut across the old one, so that it matches the natural lines on the skin and does not stand out. Its healing takes place under correction and supervision, so that the result is a neat, almost imperceptible defect. If the scar was initially hypertrophic, then it is first excised to align with the skin level, so the entire course of correction, sometimes, can take six months or a year. Patients must be prepared for this.
3. Skin grafting and flap plastic surgery are popular. Thanks to these methods, it is possible to move a serious scar from the cosmetic area to less visible places on the human body. Often used for burns and keloid scars. The scar is excised and this area is covered with skin from the donor site. As a result, instead of a scar, almost imperceptible small scars remain. This result is considered acceptable.
4. In dentistry, excision and plastic surgery of scars on the oral mucosa are also used. Sometimes, there are atypical scars on the mucous membrane, and they are excised, as they prevent prosthetics. Among these operations on the oral mucosa, various types of plastics and transplants are also used.

In addition to these techniques, there are other types of plasty, for example, W-plasty or Z-plasty and others, it all depends on what kind of scar. But all methods are effective, and these are the results that can be achieved if you treat the problem responsibly:

In any case, surgical excision or scar plastic surgery is a radical technique. Doctors advise resorting to them if the problem is really serious, and other types of therapy do not help.

Possible complications and postoperative care

To achieve the desired effect, careful wound care is required after the operation. For this, a pressure bandage is applied, somewhere for a day. Subsequently, doctors recommend not to subject the incision site to stress.

Swelling and redness are also inevitable, in such cases cold compresses can be applied. A serious complication can be inflammation of the wound, then the body temperature rises, and pain appears, you need to see a doctor, this is treated with anti-inflammatory and antibiotics.