Scar Revision Surgery in Pune: Improving Old and New Scars

What is scar revision?

A scar is the body’s way of repairing skin after an injury, surgery, burn or acne. Most scars become flatter and paler over a year or more, but some stay wide, raised, sunken, dark or tight. Scar revision is any treatment that improves how a scar looks or works. Surgery is one part of it; non-surgical treatments are another, and the two are often combined.

Common reasons people seek revision:

• Wide or stretched scars, often after wounds that healed under tension.
• Raised (hypertrophic) scars that stay within the original wound. Keloids, which spread beyond it, are treated differently; see keloid treatment.
• Depressed or tethered scars, such as acne scars or scars stuck to deeper tissue.
• Scars across natural skin lines, which catch light and shadow.
• Contractures: tight scars that limit movement, often after burns. See burn scar treatment.
• Scars that remind someone of a traumatic event or affect confidence.

Who may benefit, and how is suitability assessed?

At consultation the surgeon examines the scar’s width, height, colour, firmness, direction and position, and checks whether it restricts movement. They ask how and when it happened, how it has changed, whether you form thick scars easily, and about smoking, diabetes and medicines. Photographs are taken to plan and track treatment.

Most scars are revised after they have matured, usually 12 to 18 months after the injury. Earlier treatment may be advised when a scar limits function or is thickening.

What are the treatment options?

Option	Suits	Limitations
Silicone gel or sheets, pressure	Raised or new scars	Daily use for months
Steroid injection	Raised, itchy hypertrophic scars and keloids	Can thin the skin or lighten its colour
Laser (for example fractional CO2)	Texture, acne scars, some flat or raised scars	Several sessions; temporary redness or darkening
Subcision and fat grafting	Depressed or tethered scars	Fat may partly reabsorb; may need repeating
Excision and layered closure	Wide or stretched scars	Leaves a new, usually finer, line
Z-plasty or W-plasty	Scars in a poor direction, or tight bands	Longer but less noticeable lines
Skin graft or flap	Large contractures or scars that cannot be closed directly	Larger operation; donor-site scar

For depressed scars, fat grafting can add volume beneath the skin. Fresh cuts on the face need careful closure from the start; see facial cosmetic stitches.

How is scar revision surgery performed?

1. Planning: the new scar is drawn to lie along natural skin creases where possible.
2. Anaesthesia: usually local anaesthesia; general anaesthesia for large areas or children.
3. Removal or release: the old scar is cut out, or released and rearranged with small flaps (Z-plasty or W-plasty) to change its direction or lengthen a tight band.
4. Layered closure: deeper stitches take the tension, and fine stitches or skin glue close the surface.
5. Dressing: a light dressing or tape supports the wound.

Non-surgical treatments are often started a few weeks after surgery as the new scar forms.

How should you prepare, and what should you ask?

• Stop smoking well before and after surgery; it harms wound healing.
• Tell your surgeon about any history of thick scars or keloids.
• Avoid sun exposure on the scar.
• Plan for stitch removal and follow-up visits.

Questions to ask:

• Is my scar mature enough to treat?
• Will surgery, non-surgical treatment or both help most?
• What will the new scar look like, and how long will it be?
• How many sessions should I expect?

What is recovery like?

Time	What to expect for most patients
Week 1	Mild soreness; keep the wound dry and clean as advised
Days 5-14	Stitches removed, earlier on the face and later on the body
Weeks 2-6	Scar is pink and firm; start silicone gel and massage when advised
Months 3-6	Redness fades; laser or injections may be added
12-18 months	The scar reaches its final appearance

Protect the new scar from the sun with clothing or sunscreen for at least a year.

What are the risks of scar revision?

• A scar that is still noticeable, or wider than hoped, especially in areas that stretch.
• Hypertrophic scarring or keloid return, particularly in people prone to them.
• Infection or wound opening, uncommon.
• Colour change, darker or lighter skin, more common in darker skin types.
• Need for more than one treatment.

Contact your surgeon if the wound becomes red, hot, swollen or discharges, if it opens, or if a scar starts thickening quickly.

What results can you expect?

Revision usually makes a scar less noticeable rather than invisible. Results depend on the scar’s cause, position, your skin type and how carefully the scar is looked after while it matures. Combining surgery with non-surgical treatment often gives the most improvement.

What affects the cost of scar revision in Pune?

• Size, number and position of scars, and whether flaps or grafts are needed.
• Technique mix: surgery alone or with laser sessions, injections or fat grafting.
• Anaesthesia and facility.
• Number of sessions and follow-up visits.