Scar formation is a universal physiologic response to skin injury. The inflammation, fibroplasia, and collagen remodeling that occurs can vary greatly among people depending on the mechanism of injury, the prior closure technique, and ethnic profile of the patient. While some scars can be unnoticeable, others can be painful, raised, irregular, hyperpigmented, or chronically irritated, and occur in unsightly locations that make them noticeable. In addition, many scars, especially surgical scars will heal as a straight line, which when contrasted with the curves of the face, breast, abdomen, or extremities make them glaringly obvious.
Scar revision should be considered whenever any of these conditions may occur. Revising the scar often consists of excising the old scar and then relocating and readjusting the level of the scar or irregularizing the “straightness” of the scar to a more cosmetic location within a skin fold or along a parallel of a natural body line.
Although the scar can never be histologically totally eliminated, almost all scars can be significantly improved, and when using specialized topicals, such as impregnated sheeting can be made flat with a minimum of persistent inflammation.
Scar revision can be covered by insurance when scars cause a limitation of motion or an encumbrance of one’s activity.