Surgical Revision of Scars

Scars are the consequence of alterations in the skin’s healing process after trauma, surgical interventions, or skin diseases prone to leaving scars. Associated symptoms, decreased functionality, and an aesthetic appearance tend to have a severe impact on the psyche and quality of life of individuals bearing scars. Several surgical techniques have been developed to reposition scars toward relaxed skin tension lines, hide scars in nearby anatomical landmarks, or flatten or fill raised or depressed scars, respectively. Among these techniques, we reviewed scar revision methods ranging from simple excisions to W- and Z-plastys, advancement flaps, and geometrical closures, among others. We discuss the effectiveness and current application of dermabrasion, microdermabrasion, lasers, fractional photothermolysis, skin grafts, and soft tissue augmentation modalities. The role of adjuvant treatments including intralesional corticosteroids, 5-fluorouracil, interferons, radiation therapy, topical imiquimod, silicone, and compression is examined. Newer and potential therapies are also mentioned. In conclusion, the best long-lasting, recurrence-free cosmetic result is achieved by the combination of appropriate techniques applied to each scar in a personalized fashion.