Effective Scar Revision Techniques for Post-Injury Recovery

Scar revision

I have a large scar on my leg due to a car accident, which extends from the upper inner thigh down to a circle around the knee.
At that time, the doctors performed skin graft surgery on both sides of my knee.
Now, the edges of the skin graft are raised and red, and the entire scar on my thigh is also raised, which is likely keloid formation! There is also a small patch of skin graft near the inner side of my knee, which appears wrinkled, but this area does not have keloids.
Is there any way to repair such a large scar? The wound was very severe, and it has been about five to six years since the incident.

Chuun, 20~29 year old female. Ask Date: 2016/03/13

Dr. Lu Daokuan reply Plastic Surgery

Large scars are difficult to manage.
In recent years, there has been a surgical procedure involving fat grafting, which you can consult with a physician experienced in this technique.

Reply Date: 2016/03/13

More Info

Effective scar revision techniques for post-injury recovery can significantly improve the appearance of scars, especially in cases of severe injuries like yours. Given the complexity of your situation, including hypertrophic scars and possible keloids from the skin grafts, a multifaceted approach is often necessary.

Understanding Scarring
Scars form as part of the body's natural healing process after an injury. They can vary in appearance based on several factors, including the type of injury, the depth of the wound, and individual healing responses. Hypertrophic scars, like the ones you described, are raised and can be red or darker than the surrounding skin. Keloids are a more severe form of scarring that extends beyond the original wound boundaries and can be itchy or painful.

Scar Revision Techniques
1. Topical Treatments: Over-the-counter silicone gel sheets or silicone ointments can help flatten and soften scars. These products create a protective barrier over the scar, which can help in hydration and healing. They are most effective when used consistently over time.

2. Pressure Therapy: This technique involves applying pressure to the scar using specialized garments. It is particularly effective for hypertrophic scars and keloids, as it can help flatten the scar tissue over time.

3. Laser Therapy: Laser treatments can be beneficial for reducing redness and improving the texture of scars. Different types of lasers can target various aspects of scarring, such as pigmentation and surface irregularities. Fractional laser therapy is often used for more extensive scars.

4. Injections: Corticosteroid injections can help reduce the size and redness of hypertrophic scars and keloids. These injections can be administered at intervals and may require multiple sessions for optimal results.

5. Surgical Revision: In cases where scars are particularly large or disfiguring, surgical revision may be an option. This involves excising the scar tissue and re-closing the wound in a way that minimizes future scarring. However, this option should be carefully considered, as it can sometimes lead to new scars.

6. Microneedling: This technique involves using fine needles to create micro-injuries in the skin, which can stimulate collagen production and improve the texture of scars. It is often used in conjunction with topical treatments for enhanced results.

7. Chemical Peels: Superficial chemical peels can help improve the appearance of scars by removing the outer layer of skin, promoting new skin growth. This method is generally more effective for superficial scars and may not be suitable for deeper scars.

8. Dermal Fillers: For depressed scars, dermal fillers can be injected to raise the scar to the level of the surrounding skin. This is a temporary solution, as fillers typically need to be reapplied every few months.

Consultation with Specialists
Given the complexity of your scars and the time elapsed since your injury, it is crucial to consult with a dermatologist or a plastic surgeon specializing in scar revision. They can assess your scars and recommend a personalized treatment plan based on your specific needs and the characteristics of your scars.

Additional Considerations
- Time Factor: Since your injury occurred five to six years ago, some treatments may be less effective than they would be if applied sooner. However, improvements can still be made with the right approach.

- Skin Care: Maintaining good skin care practices, including moisturizing and sun protection, can help improve the overall appearance of scars.

- Patience and Realistic Expectations: Scar revision can take time, and results may vary. It is essential to have realistic expectations and understand that complete scar removal may not be possible.

In conclusion, while significant improvement is often achievable, the best results come from a combination of treatments tailored to your specific situation. Engaging with a healthcare professional who specializes in scar management will provide you with the most effective options for your recovery.

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