A scar is a constant reminder of a wound that once existed. It can be located anywhere on the body, come in a variety of shapes and sizes and may be raised or recessed. Some scars can be very unsightly or disfiguring and cause insecurity for an individual. Scar revision treatment at Scottsdale Plastic Surgeons is a cosmetic surgery by our board-certified surgeons, Dr. Holden and Dr. Tsujimura, that helps minimize the appearance of a scar and improve its condition. Although a scar revision can provide a more pleasing appearance or improve skin tissue that has healed poorly, it cannot be completely erased.
"Rhinoplasty - Scottsdale, AZ - I couldn't be happier with my new nose.I hated my nose for as long as I can remember, when I looked in the mirror or at pictures of myself that's all I saw. The first time I met with Dr.Holden he pin pointed my exact issues with my nose with out my having to tell him. He was very kind and patient and answered all of my questions. While talking to him it was obvious he knew what he was talking about and was an expert in his field. I felt so comfortable and confident with him that I canceled my other consultes (with another surgon I used in the past) and scheduled by surgery for the next week. Dr.Holden also saw me at every one of my follow up appointments, not some nurse, which was very important to me and helped with my post surgery anxiety. With being 34 years old and a mother of 3 it was very important to me for my new nose to look natural. It does. I am thrilled when I look in the mirror and the people close to me have all remarked how wonderful it looks. While people that I haven't shared my surgery haven't noticed or at least not enough to say "oh my gosh you got a nose job!" I still look like me. :)"- S. / RealSelf / Jul 30, 2015
"Restylane Lyft Gave Me the Lift I Needed. - Dr. Holden was very knowledgeable and he took time to discuss all options available to me."- L. / RealSelf / Dec 04, 2016
"After many consultations with several surgeons I'm happy to say I found Dr. Holden. He is hands down the best of the best when it comes to trusting someone for facial plastic surgery. Dr. Holden performed a revision rhinoplasty and chin augmentation on me. After doing extensive research, Dr. Holden was more than qualified for the job. He had the same vision I had when it came to creating the masterpiece that he did. He turned my imperfection into perfection. I'm a person who worries about every little thing, and not only did Dr. Holden answer all my questions but he never rushed me and always made me feel comfortable. Behind every phenomenal doctor is great staff. Everyone was positive, smiled and was happy to assist. Andrea provided me with step by step instructions and explained everything to me. The customer service was beyond my expectations. Dr. Holden will be the only doctor to perform any future facial plastic surgery that I may need as I age."- K.A. / Yelp / Oct 28, 2016
"Chin Implant, Lower Facelift, Fat Grafting- 42 Year Old Female- Best Decision - Scottsdale, AZ - Dr Holden was amazing- start to finish. He was very honest with me, and we discussed the best plan for my multiple issues. This was not a quick conversation and I was so impressed with the way he explained everything to me. He spent considerable time going over what the surgery itself would entail, what to expect after surgery, and my questions about recovery. He understands that this is both exciting and a bit terrifying as well- because it is my face after all. I wanted to look like myself, but with a better profile and jawline. He explained that a lower facelift, custom chin implant, as well as a touch of fat grafting under the eyes, at the temples, and at the lips would give me the results I desired.Interestingly enough, I was planning on having a different surgery for this problem, where my jaw would be broken and moved forward (orthagnathic surgery) and we spent considerable time weighing the pros and cons of both. Since my braces had largely corrected my teeth crowding and overbite, there would only be a few millimeters added with orthagnathic surgery. This would not be enough to change my profile in a noticeable way, and I would still need soft tissue reconstruction to get my desired effect. Not to mention, I would NOT need my jaw wired shut for 6 weeks with a facelift, and the pain would be remarkably less as well.Dr Holden made me feel very confident in my decision, and his advice was so valuable to me. His expertise was obvious as well. Not once did he pressure me or rush my decision, and we decided to proceed.After surgery, he was just as interested in my recovery and had frequent follow up visits. I felt he genuinely cared about my well being and outcome. I really could not be happier! I feel so grateful to Dr Holden for all the time he spent walking me through this complicated decision, and the results speak for themselves. When my friends see me now a week out, even though I'm still a little bruised and swollen, the typical reaction is tears of joy. I have several friends who are plastic surgeons, and they were impressed with my results right away as well. I am so grateful that Dr Holden was my surgeon- I have never felt so beautiful."- S. / RealSelf / Sep 11, 2016
"42 Yr Old - Amazing Breast Augmentation Experience - Scottsdale, AZ - Dr Tsujimura was the perfect choice for my breast augmentation. I trusted him immediately. He was kind, respectful, and gave me very honest feedback to my questions. I wanted silicone implants, somewhere in the 250-300cc range, under the muscle, with transaxillary placement. He discussed the pros and cons of implant types, incision location, implant placement, and implant size/profile. We agreed on a plan, and I couldn't be happier with the results. Even though I am only a week out from surgery, they look natural, symmetric, and appropriately sized for my small frame. I did not have any numbness on my inner arm or chest wall, which can happen with the transaxillary approach. I had almost no bruising either, just a little around the incisions. Pain was very minimal. He was very caring and involved during my postop visits as well, and made me feel very comfortable during my recovery. I am so grateful that Dr Tsujimura was my surgeon! I would recommend him to anyone!Also, his office staff and surgery staff are amazing- they make you feel appreciated, important, and they are all so kind and helpful! They made the experience even that much better!"- S. / RealSelf / Sep 11, 2016
Types of Scars
There are various methods available to treat unsightly scars, but it helps to first understand the different kinds of scars.
- Superficial scars are the most subtle type of scars. They do not cause any issue other than an unsightly appearance.
- Keloid scars are larger, painful scars, which are often discolored and tend to extend beyond the edges of a wound.
- A hypertropic scar does not extend beyond the wound, but it continues to become larger, thicker, and more painful over time.
- A contracture scar develops over a larger section of skin creating a tight feel and impairing one’s ability to move. A severe burn is an example of this.
Scar revision treatment will be chosen based on the scar’s location, type, size and overall extent. There are various techniques to consider.
For scars that are raised, a shave excision may be performed to remove the top of the scar and even-out the surface with the rest of the skin. This creates a smoother, flatter appearance. During the procedure, a surgical shaver is used to slowly shave off the raised portion of the scar. Sutures are not needed in most shave excision cases.
This is also a technique used for raised scars. It can be accomplished a couple of different ways. First, is the elliptical removal pattern. This involves removing the scar as well as an edging (ellipse) of skin encompassing the scar so a clean enclosure can be made. The sutures may be placed on the inside or outside of the skin. Sometimes a scar exists because the incision was closed poorly. By reopening the scar and resuturing the skin in a different direction, the new scar can be minimized.
Skin Grafting/Tissue Expansion
Large scars may require a skin graft (skin taken from another area on the body) to close the wound once the scar has been removed. Carefully placed sutures will be used around the graft to close and blend the skin together for healing. If a skin graft will not be used, tissue expansion may be used instead. During this process, a tissue expander will be placed under the skin where the scar resides and filled with a sterile solution. Once the expansion process is complete, the surgeon will stretch and join the edges together and place sutures carefully into the tissue wall.
Scars that are depressed or concave may benefit from a filler material known as injectable derma filler. There are a wide variety of fillers on the cosmetic surgery market that may be considered. Collagen is a common filler used for scar revision. During the procedure, the injectable material will be injected into the skin through a syringe. The surgeon may manipulate the outside of the skin to help shape the surface accordingly.
Some scars can be treated with a series of skin rejuvenation treatments, which can soften the surface of the skin, smooth out uneven scarring, reduce uneven pigmentation and lighten the skin where needed. Some scars may even become non-existent because of the skin removal mechanism. Skin surface treatments include laser skin resurfacing, chemical peels, dermabrasion and skin bleaching.
All scar revision procedures are performed in our surgical facility. Some procedures will require sedation, but most will only need local anesthesia. Following this procedure, patients will need to adhere to a daily scar treatment regime so the wound site and new scar can heal. It is important to protect this area of skin from sun exposure to avoid any further skin discoloration. While this treatment does not fully eliminate a scar, the visible imperfections are certainly minimized. Most patients feel more confident exposing the section of skin where the unsightly scar once resided.
The cost for scar revision treatment varies depending on what type of procedure was performed. Unfortunately, this can range from several hundred dollars for a skin resurfacing treatment, to several thousand for a surgical procedure.