An unsightly scar can be an ongoing source of distress for many, particularly when it is located prominently on the face. Whether it is from a traumatic injury, previous surgery, or a skin condition such as acne, an ugly scar mars the normal landscape of the skin. In some cases, a scar may worsen over time, growing progressively thicker or redder. If there is chronic inflammation associated with the scar, itching, pain or discharge may also be present.
Fortunately, numerous treatment options exist for scar reduction, ranging from topical products, light therapy, laser resurfacing and surgical revision. These options can lead to improvements in color, texture, thickness, and contour. For many scars, the most dramatic improvement can be achieved through surgical excision and re-closure.
Dr. Kim is highly experienced in facial plastic surgery and has taught extensively in meetings and courses about soft tissue techniques necessary to achieve optimal outcomes in scar revision. He believes that the following principles must be respected in order to have the best chance of a stellar outcome:
- Gentle tissue handling. Even minor tissue trauma can predispose to hypertrophy (thickening) of the scar in certain skin type individuals.
- Tension free closure. There should be little to no tension on the superficial edges of the skin closure. Otherwise the incision becomes a seam that has a tendency to separate—this translates into a wider scar over time. By performing a layered closure into the deeper tissue under the skin, Dr. Kim is able to minimize tension on the skin surface.
- Meticulous closure. Dr. Kim performs all of his surgery with great attention to detail. This includes the suturing of the skin layer. To the fraction of a millimeter, Dr. Kim ensures that the skin edges come together as cleanly and precisely as possible. Often using a specialty “vertical mattress” closure, he is able to maximize precision and minimize scar width.
- Diligent post-operative care and monitoring. Even after a technically flawless surgery, a scar must go through a healing process which can affect its final outcome. There are things that can be done to maximize the likelihood that this healing process will lead to the best potential outcome. Taping, topical treatment, and sun protection are critical. If the scar starts to thicken, early intervention with steroid injection, laser therapy or light therapy can be helpful to reduce unwanted healing patterns. Even after the surgery, Dr. Kim will continue to work with his scar revision patients in the healing process and provide such treatments should the need arise.