Scar Revision for Surgical Scars

Surgical scars form as part of the body’s natural healing process after procedures involving incisions or trauma to the skin. While many scars fade with time, others may remain visible or uncomfortable, especially in areas of tension or high movement. Dr. Jane Yoo offers advanced treatments and personalized guidance to help improve the appearance, texture, and symptoms of surgical scars.

What are surgical scars?

Surgical scars result from the body’s attempt to repair tissue after a cut, excision, or incision. During this healing process, the body produces collagen to close the wound and rebuild the skin’s structure. If the collagen is overproduced, misaligned, or the wound experiences mechanical tension, the resulting scar may become raised, widened, or discolored.

Scars may evolve through several phases:

  • Inflammatory phase: Redness, swelling, and initial closure
  • Proliferative phase: Collagen formation and new tissue growth
  • Remodeling phase: Scar tissue reorganizes and may fade or flatten over 12 to 18 months

Not all surgical scars follow the same path, and factors such as wound care, location, genetics, and skin type all play a role in the outcome.

Common characteristics of surgical scars

Surgical scars may vary based on how the incision healed and where it is located. Scars may appear:

  • Flat and thin
  • Wide or stretched
  • Raised and firm (hypertrophic)
  • Thick and extending beyond the original wound (keloid)
  • Discolored (darker or lighter than surrounding skin)
  • Itchy, tight, or painful in the early phases of healing

Scars on high-tension areas such as the chest, shoulders, joints, and abdomen are more prone to thickening or stretching during healing.

What factors affect surgical scar formation?

Several variables influence how a surgical scar develops:

  • Genetics: Some people naturally produce more collagen and are more prone to raised or pigmented scars
  • Age: Younger patients may scar more aggressively, while older skin may heal more slowly
  • Skin tone: Skin of color is more prone to pigment changes and certain scar types, such as keloids
  • Wound tension: Areas under high stretch or movement are more likely to widen or thicken
  • Infection or inflammation: Increases the chance of irregular scarring
  • Location and depth of incision: Deeper or more complex surgical sites may take longer to heal
  • Post-op care: Adherence to wound care guidelines is crucial for minimizing long-term scarring

How can surgical scars be prevented?

While no scar can be completely prevented, the right care can reduce its severity and visibility.

Best practices include:

  • Follow post-surgical instructions: This includes activity restrictions, wound care, and bandaging guidance
  • Minimize strain on the area: Avoid pulling or stretching the incision site
  • Keep the area clean: Reduces the risk of infection and promotes orderly healing
  • Use silicone gel or sheeting: Helps regulate collagen, maintain hydration, and flatten scars
  • Massage the scar: Once approved by your provider, gentle massage can improve pliability and circulation
  • Sun protection: UV exposure can darken and thicken scars, making them more noticeable. Always apply SPF 30 or higher to healing skin

Nutrition, hydration, and general health also support optimal healing. Vitamins A, C, and zinc play a key role in tissue regeneration.

When is it time to treat a scar?

Dr. Yoo may recommend active scar treatment if you notice:

  • Persistent redness or thickening after several months
  • Itching, burning, or discomfort around the scar
  • A raised or firm scar that limits movement
  • A scar that has widened or stretched with time
  • A keloid or hypertrophic scar that has continued to grow
  • Concerns about the scar’s cosmetic appearance

Early intervention can prevent scars from worsening and reduce the need for more invasive treatment later.

Treatment options for surgical scars

Scar treatment is rarely one-size-fits-all. Dr. Yoo creates a customized plan based on the scar’s age, location, size, and type, as well as your skin tone and healing history.

Non-invasive and minimally invasive options include:

  • Laser therapy: Fractional and vascular lasers help reduce scar thickness, fade discoloration, and improve skin texture
  • Microneedling and RF microneedling: Stimulate collagen remodeling and smooth irregularities
  • Steroid injections: Used for raised or inflamed scars to reduce fibroblast activity and flatten tissue
  • Cryotherapy: Freezes abnormal scar tissue and is especially useful for hypertrophic scars
  • Pressure therapy: Compression garments or silicone pads apply gentle pressure to help flatten and control collagen
  • Chemical peels: May be used on surgical scars with pigment changes or surface roughness

In cases where a scar is particularly symptomatic or functionally restrictive, scar revision surgery may be considered. This involves re-excising the scar and closing it using advanced techniques to improve alignment and reduce tension, followed by supportive therapies to prevent recurrence.

How long does scar remodeling take?

Scar remodeling typically continues for 12 to 18 months after surgery. During this time, the scar may gradually flatten, soften, and change in color. Consistent care, sun protection, and follow-up treatments all help support better long-term outcomes.

Is scar treatment safe for skin of color?

Yes! Treating surgical scars in Asian skin and other skin of color requires expertise and careful planning to avoid post-inflammatory pigmentation and other side effects. Dr. Yoo has extensive experience treating surgical scars in all skin tones, using laser settings, injection protocols, and topicals that are safe and effective for melanin-rich skin.