Every surgical procedure leaves a scar. The honest aim of plastic surgery is not the impossible promise of no scarring, but the achievable goal of a scar that fades to inconspicuousness over time. For patients whose previous surgery — cosmetic or reconstructive — left a scar that has not healed well, scar revision is a well-established procedure that can dramatically improve the result.
Why Scars Heal Differently
Scar quality is determined by several factors, only some of which are within the surgeon’s control:
- Surgical technique — incision placement, tension across the wound, layered closure
- Anatomical location — the chest and shoulders scar more visibly than the face
- Individual healing — genetic tendency to keloid or hypertrophic scarring
- Postoperative care — sun protection, tension avoidance, scar management
- Age and skin type — younger skin and certain skin types are more prone to thickened scars
Types of Scars That Benefit from Revision
| Scar Type | Appearance | Revision Approach |
|---|---|---|
| Widened | The scar has stretched, often appearing pale and flat | Re-excision with careful tension management |
| Hypertrophic | Raised, red, often itchy, confined to the original wound | Excision plus steroid injections, silicone therapy |
| Keloid | Raised, extending beyond the wound, persistent | Combined excision, steroids, radiotherapy in selected cases |
| Depressed/atrophic | Sunken, particularly after acne or chickenpox | Subcision, dermal filler, laser resurfacing |
| Contracted | Restricts movement or distorts surrounding tissue | Surgical release with Z-plasty or local flap |
What Scar Revision Can and Cannot Do
Revision can transform a poor scar into a good one. It cannot guarantee no scar at all. Patients who arrive expecting invisibility are working from a false premise. The realistic goal is a scar that is significantly less noticeable than the one you have now.
Non-Surgical Adjuncts
Not every scar needs surgical revision. A range of non-surgical approaches can substantially improve scar appearance:
- Silicone sheeting or gel — often the single most effective intervention for raised scars
- Steroid injection — for hypertrophic and keloid scars
- Laser therapy — particularly for redness and texture
- Dermal filler — for atrophic, depressed scars
- Microneedling and chemical peels — for textural improvement
The Importance of Timing
Scars continue to mature for twelve to eighteen months. A scar that looks unacceptable at six months may settle considerably without intervention. Surgical revision is best deferred until the scar has fully matured, except in cases of functional restriction or distorting contracture, where earlier intervention is appropriate.
Dr. Ferrando’s Approach
Dr. Giovanni Ferrando, FRCS (Plast), brings the discipline of reconstructive surgery to scar revision. His starting point is always a careful examination of the scar in question, the surrounding tissue, and the patient’s general healing characteristics. Where revision is appropriate, he performs it with attention to tension distribution, layered closure and post-operative scar management that meaningfully changes the outcome.
Frequently Asked Questions
How long should I wait before considering revision?
Generally twelve to eighteen months from the original surgery, to allow full maturation of the scar.
Is scar revision painful?
The procedure is typically performed under local anaesthetic and is well tolerated. Discomfort afterwards is mild.
Will my new scar definitely look better?
In experienced hands, the great majority of revisions produce significantly improved scars. No surgeon can promise a perfect outcome, but careful technique combined with proper aftercare gives the best possible result.
What about non-surgical options first?
For many scars, non-surgical treatment is the right starting point. Surgical revision is reserved for cases where conservative approaches have been exhausted or are clearly insufficient.
References & Further Reading
Related articles from this clinic
- Pre-Operative Checklist
- Managing Post-Surgical Swelling and Bruising
- Your First Cosmetic Surgery Consultation
External authoritative resources
Considering scar revision in London? Book a consultation with Dr. Giovanni Ferrando for an honest assessment of whether revision is right for your scar. Learn more about our scar revision service.
