Visible scars can occur after injuries and other accidents such as burns. Scars are also unavoidable after operations. What a scar will look like later depends on the personal predisposition to wound healing and the type of injury.
Various factors influence wound healing and scar formation: These include the depth of the wound, the blood supply to the wound area, the thickness and colour of your skin, and the course of the scar in relation to the fold lines of the skin.
In planned surgeries, such as a nose correction or a facelift, for example, suitable incision and suturing techniques can be used to achieve the most inconspicuous scar formation possible. Despite all care, scar correction is sometimes unavoidable.
Book an appointment over the phone (+49-89-348123) or directly in our online-calendar!
Short info Scar Correction
Operation duration
approx. 1 to 4 hours
Narcosis
twilight sleep, local & general anaesthesia
Clinic stay
outpatient or 1 – 2 days inpatient
Appear in public
after approx. 2 weeks
Sport
after approx. 4 weeks
Costs
from 2,500 €*
*bill according to scale of fees for doctors (GOÄ)
Scars in the facial area
Clean, smooth wound edges, such as those created during operations, heal more easily than jagged or bruised wound edges, as can occur with blunt injuries. Even though our patients often talk about scar removal, it is always a scar correction, because it is undisputed that scars cannot be completely removed. However, it is often possible to hide existing scars and improve their optical appearance. In addition to medication, there are established surgical procedures for scar correction which, when used individually and carefully considered, lead to good results – this is also evident in the many women we treat with WomenforWomen in developing countries. In the following, we present the most common problem areas and relevant treatment approaches.
In the facial area, even non-proliferating scars often appear as a cosmetic problem. There are different procedures for scar correction and scar removal in the facial area. If the scar lies transverse to the natural skin lines, a shift along these tension lines (e.g. through Z-plasty) can already lead to a significant improvement. Other scars on the face can be alleviated by dermabrasion. In dermabrasion, the uppermost skin layers are removed with a special, high-frequency grinding device. In this way the skin surface is levelled, but the scar is not completely invisible.
Proliferating scars/Keloids
Itchy, excessively proliferating scar tissue that grows beyond the scar boundaries is called a keloid or scar keloid. Keloids are often reddish or at least darker than the surrounding skin. Keloids continue to grow even after wound healing is complete. Keloids can occur anywhere on the body, but preferred sites are the ears, shoulders and upper chest. They are more common in dark-skinned people than in light-skinned people. The tendency to keloid formation decreases with age.
Treatment by regular corticosteroid injections directly into the keloid tissue reduces the symptoms such as redness, itching and burning and can even lead to a reduction in scarring. If the injection treatment is not sufficient, the scar tissue can be removed and then irradiated. This is usually done on an outpatient basis under local anaesthetic. One can be back at work within one or two days. Rarely a small skin transplantation is necessary to cover the resulting skin defect, but this can lead to new keloid formation at the site of skin removal.
Since keloids recur very frequently, sometimes more than before, combined treatments such as surgical Scar Correction with injection treatment or radiation must be used. Pressure bandages alone or in combination with silicone films, which must be applied over a whole year, can also delay recurrence. Nevertheless, repeated treatment is more the rule than the exception.
Hypertrophic scars
Itchy, excessively proliferating scar tissue that grows beyond the scar boundaries is called a keloid or scar keloid. Keloids are often reddish or at least darker than the surrounding skin. Keloids continue to grow even after wound healing is complete. Keloids can occur anywhere on the body, but preferred sites are the ears, shoulders and upper chest. They are more common in dark-skinned people than in light-skinned people. The tendency to keloid formation decreases with age.
Treatment by regular corticosteroid injections directly into the keloid tissue reduces the symptoms such as redness, itching and burning and can even lead to a reduction in scarring. If the injection treatment is not sufficient, the scar tissue can be removed and then irradiated. This is usually done on an outpatient basis under local anaesthetic. One can be back at work within one or two days. Rarely a small skin transplantation is necessary to cover the resulting skin defect, but this can lead to new keloid formation at the site of skin removal.
Since keloids recur very frequently, sometimes more than before, combined treatments such as surgical Scar Correction with injection treatment or radiation must be used. Pressure bandages alone or in combination with silicone films, which must be applied over a whole year, can also delay recurrence. Nevertheless, repeated treatment is more the rule than the exception.
Contractures
Injuries to the skin, such as burns that lead to loss of tissue, can create a tight, contracted scar called a contracture. The contracture may involve adjacent tendons and joints, thereby affecting or eliminating normal joint function. Surgical treatment of contractures often requires the removal of the scar followed by covering the defect with a skin flap plasty (shifting flap, Z-plasty) or a skin transplant. In addition, techniques such as skin stretching using implantable expanders can be used to correct scars. Often, after the contracture in a joint has resolved, physiotherapy must be followed until normal function is restored.
Z-plasty
Z-plasty is a plastic-surgical method for better fitting of a scar into the natural tension lines of the skin. Even in the case of contractures, a relaxation of the tissue can be achieved and thus a significant improvement in both appearance and function. Z-plasty is not the appropriate treatment method for all scars – we would be pleased to assess your individual chances of treating your scar correction in a detailed consultation. For Z-plasty, triangular skin flaps are applied at an angle of about 45° to the scar after the excision of the scar. By shifting the tips of the flaps (drawing), the result is a Z-shaped scar line, which is closed with fine sutures. Small Z-plasties are usually performed on an outpatient basis under local anaesthetic. With Z-plasty scars are less conspicuous, they cannot disappear completely.
Scar Correction through skin transplantation and flap plasty
Skin flap plasty and skin transplantation may be required for optimal plastic surgery treatment of larger scar areas. A stay in a clinic is often necessary, and depending on the planned procedure, a general anaesthetic may be appropriate. The healing phase can take several weeks and often supporting bandages and dressings are required. Skin transplantation involves the removal of healthy skin from a suitable part of the body to cover the defect in the injured area. In most cases, the transplantation of the patient’s own skin is successful and the skin grows at the new site with the ingrowth of blood vessels. Skin transplantation is associated with the formation of scars at the site of removal and reception.
Another complex procedure is the creation of a flap plasty in an individually adapted form. In this procedure, the skin with the underlying tissue, if necessary also with muscle tissue, is transplanted from a healthy part of the body to cover the injury-related defect. The blood supply of the flap plasty can either be maintained by suitable local displacement or, in the case of more distant use, guaranteed by a simultaneous microsurgical transplantation of blood vessels. Skin transplants and flap plasty can serve well to improve function in a large scar area, but the cosmetic results can sometimes be less satisfactory, as the transplanted skin can differ in colour and texture from the surrounding area. In general, however, the use of flap plasty leads to better cosmetic results than skin transplantation.
What kind of narcosis is used?
The scar correction can usually be performed under local anaesthesia with injection of local anaesthetic. For larger operations, especially for flap plasty, a general anaesthetic may be necessary. Of course, your wishes will also be taken into account in this matter. In case of local anaesthesia, a sedative (either as a tablet or as an intravenous injection into the arm vein) is additionally given, which causes a kind of twilight sleep. You are awake, but relaxed and insensitive to pain. You may feel a pulling or similar sensation in the operating area. With a general anaesthetic you will sleep throughout the procedure. Before the surgery, an anaesthesiologist clarifies your suitability for anaesthesia. The anaesthesiologist is present during the entire operation and controls the narcosis.
How does a treatment in the clinic of Dr. von Isenburg & Dr. Neuhann-Lorenz take place?
1 Personal consultation
Prior to any scar correction, our team provides the patient with comprehensive information about the planned procedure and its risks. It may be helpful for you to make a note of your questions in advance. Do not be afraid to ask anything that interests you. Inform yourself, if necessary by telephone or at another preliminary meeting, if problems remain open. The declaration of consent is a document in which your personal data, the planned treatment and any complications mentioned are recorded. Your signature guarantees that you have received the appropriate information and that you agree with your treatment or that of your child, knowing the general and specific risks.
2 Clarifying the risks
In general, it is a harmless treatment that usually runs completely smoothly. Exceptions are temporary swellings and redness after the operation, which vary in severity from patient to patient but subside after a few days. In rare cases, these symptoms can last longer than a week. Milia, skin dryness or skin discoloration also occur occasionally. Scarring due to wound infection cannot be completely ruled out but is extremely rare. Risks, such as wound healing disorders, can be well assessed prior to the procedure, depending on the patient’s state of health and lifestyle, and thus individually prevented.
In addition, we ask you to sign a declaration of consent before the surgery, which is provided with your name and date of birth and in which the type of surgery and all possible complications mentioned are recorded. Your signature will ensure that you have received the appropriate information and that you agree with the operation while being aware of the risks.
3 The preparation & the treatment
You should be in optimal overall health, especially before a planned surgical intervention. Please limit nicotine and alcohol consumption to a minimum. If you are taking medication regularly, please discuss the intake in detail with your surgeon. The intake of hormone-containing medication (contraceptive pill, hormone replacement products) may have to be stopped temporarily. In any case, you should not take aspirin or similar medication for at least seven days before the operation. In consultation with your surgeon, it may be necessary to plan for days off after the operation after major operations under general anaesthetic.
What should be considered after a Scar Correction?
Directly after the surgery
Following a scar correction with local anaesthesia, you will feel back to normal within a few hours after the operation, depending on your activities. Since the type, extent and localisation of scar correction can vary greatly, it is difficult to formulate general tips for behaviour after the surgery. Slight pain, later pulling and burning during healing are not unusual. Usually these complaints can be relieved by immobilization and appropriate medication. The bandage should of course be worn exactly as instructed by the doctor. The skin sutures are usually removed after one week.
Restrictions & recommendations
You should never use so-called “scar ointments” without consulting your doctor. Only your doctor can recommend aftercare that is adapted to your individual needs and stage of development. The final result of the Scar Correction depends on the type, size and course of the scar. In addition, individual wound healing, postoperative protection and suitable scar aftercare play a role. It can take up to a year for the scar to mature enough for the final result to be determined.
Can a Scar Correction be repeated?
In principle, it is possible to repeat a Scar Correction in almost every case. Occasionally it can be useful to plan a treatment in several steps to achieve an optimal result. Regular check-ups with your plastic surgeon will help to detect and treat any complications at an early stage. If problems occur, it is possible to weigh up what corrective measures will be taken in each individual case.
The costs!
Scar Correction generally serves to improve the external appearance, which is why the costs of scar treatment are usually not covered by health insurance companies. However, in the case of scar correction due to injury or illness, the costs are often fully or partially covered by health insurance.
Where in Munich does the Scar Correction take place?
Small scar corrections can be carried out on an outpatient basis, with local anaesthetic, in our practice or in one of our clinics. Larger surgical procedures for Scar Correction may require a short in-patient stay of a few days at the clinic. This also ensures post-operative monitoring by medical staff.
Book an appointment over the phone (+49-89-348123) or directly in our online-calendar!
