There are a number of effective treatments are available for scar revision, especially if you have a scar that's painful, itchy or unsightly, or if it restricts your movement. Scars can't be removed completely, but they can be made less visible with surgery.

What causes bad scarring? 

Scars are unique to the individual and circumstance in which they are formed – they are the body’s natural way of healing from an injury, and are unfortunately unavoidable. The way they develop is also unpredictable. Poor healing may contribute to scars that are obvious, unsightly or disfiguring. Even a wound that heals well can result in a scar that affects your appearance. Scars may be raised or recessed, different in color or texture from surrounding healthy tissue or particularly noticeable due to their size, shape or location.

Some people produce better scars than others, for example ‘poor scars’ such as hypertrophic or keloid scars stay visible and cause skin irritation for a number of months. When these ‘visible’ scars fade they tend to whiten and remain equally visible – unlike a ‘good scar’ which blends in well with the surrounding tissue.

Scar revision surgery:

Scar revision surgery will minimize a scar so that it is less conspicuous and blends in with the surrounding skin tone and texture. 

Scar quality is important to us and to our patients. Our approach is to manage scars before they become a problem so that patients don’t need to worry about them in the future. We are the first clinic to develop and offer a Scar Management Programme to all our surgical patients. We cannot guarantee a perfect scar, but we give your body the very best chance, and as soon as the wound is healed you surgeon will start you on a scar treatment plan tailored around your needs.

All scar cases are unique, and as such we advise you to arrange a consultation to discuss your case in detail.

 

Frequently Asked Questions

Many patients who have a caesarean section develop tethering of their scar causing a bulge above the scar which, even in slim people, is visible through clothing.  At Cadogan Clinic we have a simple procedure to correct or improve C Section Scars under local anaesthesia: Cadogan Caesar Correction (CCS).

From £4,150 (Fellowship led £2,698)

From £1,900 (Fellowship led £1,235).

Some people produce better scars than others, for example ‘poor scars’ such as hypertrophic or keloid scars stay visible and cause skin irritation for a number of months or years after formation. When these ‘visible’ scars fade they tend to whiten and remain equally visible – unlike a ‘good scar’ which will fade significantly and blend with the tone of the surrounding skin.

We offer both superficial and more invasive treatment options (e.g. surgical, dermatological and aesthetic) to combat bad scars. All scar cases are unique, and as such we can guide you in arranging a consultation with the very best suited specialist for your needs. Whatever your personal requirements, Scar Revision Surgery at the Cadogan Clinic can provide you with the leading experts and techniques for your treatment.

Scar revision surgery is performed to improve the appearance of a scar wherever on the face or body, but it is also often carried out to improve functioning as the formation of a scar can interfere with the movement of muscles and joints. A shortening or tightening of the skin and underlying muscles can accompany severe scars and this is known as contracture. Contractures may interfere with a range of motion and other aspects of joint functioning, as well as deform the shape of the scarred body part or affect the muscles in the face responsible for controlling facial expressions.

AT A GLANCE

• SURGERY TIME 1 hour (although depends on the complexity of the scar)

• HOSPITAL STAY Day case

• REASONABLY MOBILE: Immediately

• WASHING Shower after 1 week, bath after 2 weeks.

• DRIVING: 1 week

• EXERCISE INCLUDING GYM 2-6 weeks (again depends on the complexity and position of the scar)

• FULL RECOVERY 2 weeks

• TIME OFF WORK None

In many cases scar revision or scar improvement techniques can be carried out non-surgically, however in other cases, surgical intervention is required and can either be carried out either under a local or a general anaesthetic would be used depending on the complexity of the surgery. This very much depends on the severity of your scar and the results your surgeon can achieve – each of these aspects of surgery are discussed during your initial consultation and examination.

SURGICAL EXCISION - This is a procedure in which the surgeon shaves down and cuts out scar tissue to reduce the size of the scar. This technique is most commonly used on large scars that cannot be treated adequately with medications or other nonsurgical means. When excision is done in stages, it is referred to as "serial excision." This is performed if the area of the scar is too large to remove at one time without distorting nearby skin.

FLAPS, GRAFTS, AND ARTIFICIAL SKIN.- Flaps, grafts, and artificial skin are used to treat contractures and large areas of scarring resulting from burns and other traumatic injuries. When there is not enough skin at the site of the injury to cover the incision made to cut out and remove the scar tissue, a skin graft (thin layer of skin) from another part of the body carefully matching colour and texture is placed over the excision site. The graft tissue itself is harvested preserving its own blood supply so that the donor tissue can successfully ‘bed in’ to its new location.

Z-PLASTY AND W-PLASTY. Z-plasty and W-plasty are surgical techniques used to treat scarring contractures and help to minimize the visibility of scars by repositioning them along the natural lines and creases of the skin. They are not usually used to treat keloids or hypertrophic scars. With a Z-plasty, your surgeon makes a Z-shaped incision with the middle line of the Z running along the scar tissue - the flaps of skin formed by the other lines of the Z are rotated and sewn into a new position that reorients the scar about 90 degrees. In effect, the Z-plasty minimizes the appearance of the scar by breaking up the straight line of the scar into smaller units. A W-plasty is similar to a Z-plasty in that the aim is to minimize the visibility of the scar by turning a straight line into an irregular one. The surgeon makes a series of short incisions to form a zigzag pattern to replace the straight line of the scar. The primary difference between a Z-plasty and a W-plasty is that a W-plasty does not involve the formation and repositioning of skin flaps. 

The incision sites are usually very discreet indeed but this does again depend on the complexity of the scar to begin with and the surrounding tissue and the technique employed – in all cases the aim of a scar revision treatment is to minimise the existing wound site, so your surgeon will discuss in detail their preferred techniques during consultation

It is not uncommon to experience altered sensation following your treatment, this may either manifest in increased sensitivity (or discomfort), or the loss of any feeling at all (numbness) in the treated area. These changes in sensation usually occur for a few weeks following surgery.

Most patients can return to work on the third day after surgery. Although it is recommended that you take a few days off work – exact instructions will be provided by your surgeon depending on the complexity of your treatment.

The most important aspect of long-term aftercare is protecting the affected area from the sun because the surgical scar will take about a year to mature and is only about 80% as strong as undamaged skin. Sunlight can cause burns, permanent redness, loss of pigment in the skin, and breakdown of the collagen that maintains the skin's elasticity.

Aftercare following the use of skin grafts or flaps is slightly more ridged. You will be scheduled to return to the clinic at regular intervals so that your graft sites can be monitored. If artificial skin has been used you must keep the site(s) completely dry until advised otherwise – this may require specific restrictions around bathing or showering as well as clothing choice, i.e. wearing loose comfortable clothing can help reduce the disturbance to the treated area.

Massaging the treated areas after surgery when comfortable enough to do so (usually 2 weeks following surgery) is a very important part of the healing process and helps to soften your skin, adjacent tissue, and helps accelerate healing - you will be given exact instructions about aftercare and which movements when massaging would be best.

You will experience discomfort over the first few days following surgery, however, the degree of pain does vary from person to person.

If you have young children, babies or pets, please ensure that the area(s) treated are not pushed, kicked or disturbed for at least 1 week. Your tissues have been agitated and require a period to heal without further disturbance. It is recommended that you organise help with caring for young children (lifting/carrying) during the first few days of recovery.

Wounds must be kept completely dry for the first week. If you have had surgical treatment you may be able to shower after this first week. After your first post-operative check with the nurse at the end of week 1, you will be advised that you can shower or bath as usual.

Do not sit out in strong sunlight for the first 2 weeks after surgery. Once fully recovered and the scars are matured you may expose areas on the body or face that have been treated (this is usually after 12 months).

What to expect

Free Consultation with a Patient Advisor

We offer a free, no-obligation 30-60 minute consultation with one of our Patient Advisors. They will work with you to understand your objectives and the results you want to achieve, talk you through the procedure and answer any questions you may have. If you decide that you would like to proceed to the next step and see a surgeon, your Patient Advisor will be happy to arrange this for you. At this point, you will be required to pay a consultation fee. 

Surgical Consultation

The next step is for you to meet your chosen surgeon at the Cadogan Clinic. Your surgeon will use this time to make a comprehensive medical assessment of you, your condition, and your expectations before making a recommendation and personalised treatment plan for you. You will then discuss the outcomes you can expect to see and ask any questions.

The Procedure

On the day of your procedure you will be welcomed at the Cadogan Clinic by your Patient Advisor and dedicated nursing staff. Following a brief medical check, you will meet with both your surgeon and anaesthetist to run through the details of your procedure one final time and answer any last questions you may have.  

Recovery

After the procedure, you will recover in the capable hands of our aftercare team. As we are a day-case facility you can expect your recovery to be complete within 2 to 3 hours. If your surgeon is happy with your results, you will be able to be discharged from the Clinic the very same day. In some cases patients may wish to stay locally in our exclusive partner hotel the day before or after your procedure in order to be close to their surgeon. Talk to us about these options if this is for you. 

After Care & Support

Our care and support continues in the days and weeks following your procedure with our complimentary aftercare programme. This comprised of a series of appointments made with your surgeon and nursing team to monitor your progress and recovery. They will also introduce you to several scar minimization techniques and bespoke products to aid your progress. Our team are also on call to answer any questions you have around your surgery at any time you are concerned.