Features of extended scars
The longer the scar, the more difficult it is to bring the edges together without tension. The surgeon peels off the tissue more widely, suturing the wound in layers - first deep layers that relieve tension, then an intradermal suture. For scars that cross joints or natural folds, Z-plasty is used to avoid tightening and restriction of movement. The operation is more extensive and requires careful postoperative care.
Why can't a scar be completely removed?
Any cut in the skin heals through the formation of a scar - this is the only way of recovery available to the body. Therefore, the task of the operation is not to “remove the scar,” but to replace a wide, retracted or deforming scar with a thin and inconspicuous one, located along the lines of skin tension.
The result depends not only on the technique, but also on the individual tendency to scarring, localization and subsequent care. Scars always form worse on the sternum, shoulders and back than on the face.
Types of scars
- normotrophic - at the skin level, the most favorable
- atrophic - retracted, below skin level
- hypertrophic - protruding, but within the boundaries of the wound
- keloid - grows beyond the wound, prone to relapse
When to operate
A fresh scar takes 6–12 months to mature: it gradually turns pale, flattens and softens. It is not advisable to operate earlier - the result may be worse than the natural result of maturation. The exception is scars that limit movement or deform facial features.