There are different types of scars such as:

• Keloid scars: thick, raised scars that grow beyond the edges of the wound.
• Hypertrophic scars: thick, raised scars that grow within the confines of the wound.
• Contractures: occurs when large areas of skin are affected. A contracture scar causes skin tightness by pulling the edges of the skin together.
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The type of scar that forms depend on a variety of factors, these are: 

• Genetics
• Thickness and colour of your skin
• Size, depth, location, and orientation of the wound
• Surgical technique used to close the wound
• Post-operative care 

• Surgical scar revision: suitable for individuals with extensive scarring that may affect the function of a limb. Types of surgical scar revision include, skin grafts/flaps, Z-plasty. 
• Non-surgical scar revision: suitable for individuals with less extensive scarring. Types of non-surgical scar revision include, steroid injections, cryotherapy, pressure therapy.

Scar revision for keloids or hypertrophic scars:

• Steroid injections: steroids are injected directly into the scar to improve its appearance, reduce itchiness, decrease redness, and sometimes reduce the size of the scar.

• Cryotherapy: used together with steroid injections. The scar is frozen off in cryotherapy.

• Pressure therapy: pressure is applied on the scar using a pressure appliance that is worn above the scar for 4-6 months.

• Laser surgery: used to smoothen the scar.

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Scar revision for contractures:

• Skin graft/flaps: replaces or attaches skin to a part of the body that is missing skin. 

• Z-plasty: works by changing the direction of the scar and how it attaches to the skin

• Improvement in appearance of scar
• Improvement in symptoms related to presence of scar (pain, itching)
• Improvement in function and range of motion related to the scar

‍Medical history

It is important to give honest answers with regards to your medical history. This allows your surgeon to make accurate and safe decisions with regards to the procedure. Inform your surgeon about any medications, surgeries, or allergies you have/had. You must also inform your surgeon if you have diabetes, circulatory problems, thyroid problems, and other health issues if any. 

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Physical examination

Your surgeon will conduct a physical examination and help to identify any problem areas that can be treated with scar revision. 

After this, you and your surgeon will discuss the options available and the possible results with each option. Once the treatment plan has been decided for you, your procedure will be booked. Before the procedure, you must:

• Stop smoking: smoking reduces blood flow to the skin and hinders the healing process. It also increases your risk of tissue damage.
• Stop some medications: medications such as aspirins and anti-inflammatory drugs are blood thinners which may increase bleeding during and after the procedure.

Depending on the scar, it can involve a non-surgical or surgical treatment, or in some cases both are required. During your personalised consultation, Dr Andrew Cheah, a board-certified Plastic Surgeon, will be happy to discuss with you on the most suitable procedure to achieve your desired results.

This depends on the type of procedure suitable for your scar. In general, the steps are as follows:

• Anaesthesia or numbing cream is applied to the treatment area
• The appropriate treatment is performed to improve the appearance of your scar or improve functionality of your limb.
• Once the procedure is completed, you will be monitored and depending on the extent of your procedure, you may be required to stay overnight for monitoring.