When is surgery necessary to treat scars?

In the treatment of a scar the first step consists of topical treatments with creams and patches. These treatments are usually sufficient for small or uncomplicated scars.

In cases of scars secondary to larger wounds or in more visible or complicated areas, some invasive procedures such as CO2 laser, dermabrasion, micropigmentation or hyaluronic acid injections can be helpful.

However, there are scars that despite the previous treatments, have characteristics that require surgical treatment as they can affect self-esteem or a person’s ability to perform certain functions.

To consider a surgical treatment of a scar, it must have passed the inflammatory phase and should be stable. This usually occurs 12-18 months after the initial injury that caused the scar. We also know that the passage of time can improve the aesthetics of the scar, and after a certain time, having cared for the scar properly intervention may not be necessary.

There are different surgical treatments to treat scars. The rule is usually to transform the scars so that they follow the lines of minimum tension that the skin has, so that the aesthetic quality is better.

In the case of scars that are wide but in which there is no retraction or elevation or a keloid has developed, it may be sufficient to open the scar, bring the ends of the skin back together and restart the healing process.

In larger or irregularly shaped scars, other surgical techniques such as z-plasty or w-plasty are necessary, skin grafts could also be considered.

In any case, we must bear in mind that the surgical treatment will involve new subsequent treatments for the wound and a new healing process would begin.

A simple surgery can be performed in a short time and under topical anaesthesia. In the case of larger or more complex scars, general anaesthesia and sometimes a surgical solution that will be performed over several stages, may be necessary.