Hypertrophic scars ad keloids are not only an aesthetic type of issue. Extensive burns or wounds in articular regions can lead to
contractures, causing a functional deficit. In many cases, plastic surgery allows to correct the scars, both in the appearance and
contracture aspects. In the recent years, the option to treat post-radiation skin lesions has also appeared.
The human body has some small capabilities to heal through regeneration. All wounds of soft tissues, regardless of the method of their reconstruction, heal through the scarring process. Therefore, elimination of the existing scar or performance of any surgery without its formation is not possible. However, plastic surgery allows in many cases to correct the appearance of an anaesthetic scar or to hide it in an unexposed body area.
There are multiple methods for this. In certain cases, cutting out the old scar and stitching the wound back using the plastic surgery techniques is possible. More complex methods, such as Z-plasty or W-plasty, allow for concurrent correction of appearance and release of the scar contracture. In case of extensive scars, it is sometimes necessary to employ a skin graft or a tissue expander. In the recent years, a new, little invasive correction method for scars ad post-radiation lesions with use of the autologous tissue has been developed.
Research shows that autologous fat tissue grafting results in "softening" of the scar structure and improvement of its appearance. This method has also a positive effect on typical post-radiation skin and subcutaneous tissue lesions. Certain research papers suggest that this procedure results in withdrawal of fibrosis of soft tissues related to the radiation disease.
Sometimes, surgical treatment is not indicated. An example is a small hypertrophic scar the therapy of which should start with steroid injections and compression therapy. Fractional and pulsed dye laser are also applied in correction of certain types of scars. On the other hand, keloid requires a combined therapy, including application of steroids, surgical resection and radiotherapy. All the available scar correction methods are discussed with the patient in detail during the consultation. In the early period of scar existence, its proper care is of great significance. Wound healing is a process stretched over time. It lasts ca. 12 months and the patient has a react impact on the final appearance of the scar through their own actions. All my patients are educated in the scope of scar care in the post-operative period.
The treatment plan is set individually for every clinical case. During the consultation, I discuss the available therapeutic options with the patient. Selection of the best method depends on many factors, such as size, age and type of the scar, quality of surrounding soft tissues, past injuries or diet. The patient's attitude and level of expectations regarding the achieved result are also key.