About Scar Revision
As a very common skin issue, scars can be located anywhere on the body and face. In some cases, a scar is a reminder of a wound that once existed or another condition that caused a disruption to the skin’s surface. While most scars are not a problem, some scars are unappealing and unsightly. They can be too big or too wide, bumpy, dark, raised, or recessed. Depending on where the scar is located and its condition, scar revision surgery may be needed to improve its appearance. New York plastic surgeon Dr. Michael Koch offers scar revision surgery at our three facilities, which is an elective treatment that works to reduce the size and improve the appearance of your scar.
Types of Scars
There are several different types of scars. The type you have can dictate the best technique to address it. The most common scars Dr. Koch treats are:
- Superficial Scars
These are the subtlest type of scars. They do not cause any issue other than an unsightly appearance.
- Keloid Scars
These scars are more noticeable in size and can be sometimes painful. The skin around the scar tends to be discolored and reaches beyond the edges of where the wound once existed.
- Hypertrophic Scars
This type of scar can also be large in size. They may become thicker and grow bigger over time; however, they do not commonly expand beyond the wound site.
- Contracture Scars
This type of scar is considered more complex as it forms over a bigger area of skin. A burn is an example of this type of scar. Many times a contracture scar feels stretched and also restricts movement in some patients.
"Professional and personable - As a patient in the midst of breast reconstruction due to cancer, Dr. Koch and his team have been so incredibly helpful from the start with drawing and notes that made it easier to understand during a very hard time. Dr. Koch helps to clarify at each step of the way and has been available to answer questions, respond to calls, and work through my confusion as the cancer process unfolded and the reconstruction work is now in progress. I am so grateful that he is my surgeon and absolutely recommended him."- Anonymous / Vitals / Apr 19, 2019
"Dr.Koch and his staff are truly amazing!!!! Dr.Koch listened to my wants explained everything to to me multiple times. He also showed me EXACTLY what he would be doing for both my procedures. His staff is also the best! Everyone gets back to you in a timely fashion and they are always helpful no matter what the situation. They make you feel like they have known you forever. I highly recommend Dr.Koch and I would truly use him again."- Anonymous / RateMDs / Apr 07, 2021
"Amazing from Beginning to End - Dr.Koch and his staff are truly amazing!!!! Dr.Koch listened to my wants explained everything to to me multiple times. He also showed me EXACTLY what he would be doing for both my procedures. His staff is also the best! Everyone gets back to you in a timely fashion and they are always helpful no matter what the situation. They make you feel like they have known you forever. I highly recommend..."- P. / RealSelf / Apr 07, 2021
"Dr. Koch and his Staff went above and beyond protocol to insure my fears and doubts of my injury, also he explained in great detail of the process and best course of action. I am greatful to have a Doctor like Dr. Koch and his great staff. Patient-JS"- Anonymous / Healthgrades / Mar 23, 2021
"I have a history of breast cancer and have had over 20 surgeries all with complications to follow. I wish I had known about Dr. Koch 15 surgeries ago because I wouldn’t be writing my story. My previous surgeon was neglectful and didn’t take the precautions to ensure a safe and healthy recovery. I am so grateful I have found Dr Koch through another surgeon. Dr Koch is by far the most gifted surgeon. He performed a 9.5 hour surgery that was complicated. I am so excited to finally have hope because of this amazing surgeon."- D.B. / Healthgrades / Oct 28, 2020
Adults or children who have a scar that is bothersome, unsightly, or causes self-consciousness and insecurity may be good candidates for scar revision treatment. It is important for patients at our practice who get this procedure to be aware that while this treatment is meant to improve the appearance of the scar and reduce its size, it will not make it fully disappear. The type of surgery selected will be contingent on where your scar is located, the type of scar it is, and the size, shape, and depth.
Surgery to revise scars are typically done at one of our surgical locations. Dr. Koch will use a local anesthetic or sedation depending on the extent of the procedure. For thick or bumpy scars, a shave excision can be done to level and even out the scar. Scars that are larger and raised may be reduced in size using an elliptical incision, which removes the scar and some of the tissue and skin around it. The skin is then stitched close with a new, clean line. For scars that were caused by poor closure, this can create a dramatic improvement. Large scars or contracture scars sometimes will include a skin graft or tissue expansion so that the old scar can be eliminated, allowing healthy skin to be sewn together. In some cases, it is not the size or shape of the scar that is the concern, but instead the color or texture. There are many state-of-the-art noninvasive laser treatments that can improve the color and visibility of a scar, without a surgical procedure. Also, if you have a recessed scar or one that appears "pitted," Dr. Koch may discuss an injectable dermal filler product to create a more natural, even skin texture.
What to Expect
After a scar revision procedure, wound care is the most important component of the post-treatment process. Dr. Koch or a member of his staff will give very specific rules and suggestions to help you take care of your incision so that the new scar is smaller, lighter, and thinner. Keep in mind that the scar won't be fully removed, but most scar revision surgeries can create a natural, softer appearance.
Frequently Asked Questions
How much does it cost?
The cost of your procedure relies on a variety of factors including the area being treated, the type of scar, and the size of the scar. During your consultation, Dr. Koch can provide an estimated cost of your procedure. We also accept many payments and can help you find low interested medical financing.
What about scarring?
Post-surgery care is critical when it comes to scar revision. Patients must adhere to the medications and proper wound care to promote better healing of the new wound resulting in a less visible scar. Although a scar will still exist on the site, patients note a significant improvement. It usually takes between six months and longer for optimal results.
Scars that are depressed or concave may benefit from an injectable filler. There are a wide variety of fillers on the cosmetic market that may be considered. During the procedure, the filler will be injected into the skin through a syringe. Dr. Koch may manipulate the outside of the skin to help shape the surface accordingly.
Can this be combined with another procedure?
Yes. Typically, treatments will often include a dermal filler or laser skin resurfacing. Laser treatments are especially ideal if you are concerned about other skin issues such as hyperpigmentation or rough skin texture. During your initial meeting with Dr. Koch, it’s important that you discuss all your concerns so he can help address your cosmetic needs with a customized treatment plan.
Does it hurt?
Since some form of anesthesia is used, patients typically experience little to no discomfort during treatment. After the procedure, patients may feel sore, itchy, or experience some mild redness and swelling.
Plan Your Procedure
Improve Your Scar's Appearance
If you have an unattractive scar that bothers you, each of our New York facilities offer many procedures to make it less obvious. After assessing the size, shape, depth, and type of scar you have, a revision treatment will be created to help improve its appearance. Using surgical and nonsurgical treatments, Dr. Koch will adjust the scar area and skin around it for a more normal and natural appearance. We invite you to call one of our locations to schedule your scar assessment and consultation.