Facial scar revision
Surgical improvement of facial scars from injury, surgery or infection, by a surgeon whose specialty is the face.
What scar revision can and cannot do
No scar can be removed entirely. What surgery can often do is make a scar less noticeable: finer, flatter, better aligned with the natural lines of the face, or less tethered to the tissue beneath it. Whether that is achievable, and how much improvement is realistic, depends on the scar, its position and how your skin heals. Chris will give you an honest assessment rather than a promise.
He treats scars from facial injuries, previous surgery and healed infections, including scars that are wide, raised, depressed, stretched or lying across the natural skin creases. Maxillofacial surgeons repair facial injuries as part of their daily work, and Chris has written on the repair of facial lacerations, so the management of scars is a natural extension of that.
Timing
Skin continues to remodel for a year or more after a wound has healed, so scar revision is normally carried out at least twelve months after the original injury or surgery. Chris will advise waiting until a scar has settled before operating on it, and in the meantime may suggest simple measures such as silicone gel, massage and sun protection that improve the final result on their own.
Techniques
Most scar revision involves removing the scar and carefully closing the skin again, placed and stitched so that the new scar is finer and lies along the natural lines of the face. Thick or overgrown scars (keloids) are sometimes treated with steroid injections after removal to reduce the risk of recurrence. Procedures are done under either local or general anaesthetic in a day‑case setting, and most patients return to normal activity within a few days. Stitches are usually removed after five to seven days, and the new scar looks red for some months before it fades.
Do I definitely need treatment?
Not necessarily. Chris will first establish whether treatment is needed at all and whether there are reasonable alternatives to surgery. He may recommend leaving things alone when:
- the scar is less than a year old and still maturing, when it will improve on its own and surgery now could make it worse
- silicone gel, massage and sun protection are likely to get most of the improvement without an operation
- the scar is fine but the position is the problem, and the honest answer is that a new scar would not be any better
What does the next week look like?
A typical recovery. Yours will be discussed with you individually before you decide to go ahead.
- That evening
- A small dressing, mild discomfort. Keep it dry.
- Day one
- Slight swelling and bruising. Keep the wound clean.
- Days 2 to 3
- Bruising at its most noticeable.
- By one week
- Stitches out at 5 to 7 days. The new scar is red and will fade over months; massage and sun protection from about two weeks.
- Practicalities
- Driving
- Same day after a local anaesthetic. Not for 48 hours after a general anaesthetic.
- Work
- Next day, or a few days if you would rather not be at work with a dressing on your face.
- Eating
- Normal.
Chris's view
"I can't make a scar disappear and I won't pretend otherwise. What I can often do is make it finer, flatter and lying where the eye doesn't go. Whether that's worth an operation is the patient's call, made with honest expectations."
Mr Christopher VinallWhen should I get advice?
Arrange an assessment once a scar is at least a year old if it is wide, raised, tethered or running across the natural lines of your face, or if a scar from injury or surgery is affecting your confidence and you would like an honest opinion on what could be improved.