Patients seeking scar revision should be emotionally prepared to accept several facts:
Removal will result in another though, hopefully, improved scar
The final appearance will not be evident for 6 to 18 months
More than one procedure may be required.
Scar revision often requires at least two and frequently three surgical procedures to obtain the best achievable result. Usually 6-12 months separate each stage. Some scars “mature” more quickly therefore, subsequent stages may be performed sooner. Later stages of scar revision are typically reserved for resurfacing procedures such as dermabrasion or laser therapy in an effort to smooth out and blend the scar.
Possibly conditioned by what they see on television and in the movies, many people expect the final result immediately and become disappointed and troubled because they have to wait for “maturation” of their scars. Maturation is the continuing change in appearance all scars go through until they reach a state where no further change will occur.
Maturation of scars may take from 6 to 18 months; sometimes longer, especially in young children. Initially, a freshly repaired incision of scar usually looks pretty good. Then it becomes reddened, possibly somewhat raised above the surrounding skin and frequently is hard or lumpy. Gradually, (unless the scar is frequently stressed by stretching the surrounding skin) the firmness and red color lessen and should disappear, leaving a softer scar which is usually more level with and somewhat lighter in color than the adjacent skin.
One of the paradoxes of healing is that scars on younger children may take 18-24 months, sometimes longer, to mature, while the same scar on a patient in their 60’s may be flat, thin and soft within 3 months. This is one of the unpredictable factors that accounts for the variability in the final result that occurs with scar revision and wound healing.
Some swelling and discoloration can be expected with any surgical procedure. It can be minimized by applying ice over the operated area during the first 48 hours.