Scar Revision
ABOUT THE PROCEDURE
Scars are an unavoidable consequence of surgery and injury, but not all scars heal equally well. Some scars widen, raise, contract, or are positioned in ways that cause cosmetic concern or functional limitation. While no technique can completely eliminate a scar, a well-planned and well-executed revision can make a problematic scar significantly less noticeable, improve skin texture, and restore movement where a scar has become restrictive.
Mr Ibrahim takes a considered approach to scar revision, often advising patients to allow adequate maturation time (typically twelve to eighteen months) before surgical intervention. Many scars improve substantially with non-surgical treatment during this period, and proceeding too early can produce a result no better than the original.
Non-Surgical Treatments
Non-surgical options are often the right starting point and include:
Silicone gel or sheets: Applied consistently for three to six months to flatten and soften hypertrophic scars.
Corticosteroid injection: Reduces inflammation and flattens raised scars. Multiple treatments spaced four to six weeks apart are often needed.
Laser treatment: Pulsed dye laser for redness; fractional laser for texture and irregularity; pigment-specific lasers for discolouration.
Pressure therapy: Compression garments for hypertrophic scarring, particularly post-burn.
Surgical Techniques
When non-surgical treatment is insufficient, surgical revision offers the following options:
Scar excision and re-closure: The scar is removed and the wound re-closed with meticulous plastic surgery technique — layered closure, minimal tension, and incision reorientation along natural skin lines.
Z-plasty: A Z-shaped incision reorients and lengthens a contracted scar, breaking up a straight line and reducing its visibility. Particularly effective for scars that cross natural skin lines at unfavourable angles.
W-plasty and geometric broken line closure: Create an irregular zigzag pattern that disrupts a straight scar and improves camouflage along its length.
Scar excision with skin graft: For contracture scars restricting movement, excision and grafting releases tightness and restores function.
Fat grafting: Autologous fat can fill depressed scars and may improve tissue quality around the scar.
Your Recovery
Simple excisions involve minimal downtime — return to most activities within one to two weeks. More complex revisions may require two to four weeks off work. The new scar will be initially red and raised, improving progressively over twelve to eighteen months with diligent scar care including silicone gel, gentle massage after healing, and consistent sun protection.
Risks & Complications
The new scar may heal no better than — or worse than — the original, particularly in patients prone to hypertrophic scarring or keloids
Wound healing problems or separation
Infection or haematoma
Changes in skin sensation
Skin discolouration
Need for multiple procedures
Frequently Asked Questions
Can my scar be completely removed? No technique can eliminate a scar entirely. The goal is to exchange a problematic scar for one that is thinner, flatter, or better positioned. Mr Ibrahim will give you an honest assessment of what improvement is realistically achievable for your specific scar.
When is the right time to have scar revision? For cosmetic concerns, most surgeons recommend waiting twelve to eighteen months for the scar to fully mature. For functional problems — such as contractures limiting movement — earlier intervention may be warranted.
What about keloid scars? Keloids are particularly challenging as they tend to recur after excision. Mr Ibrahim combines surgical excision with adjunctive treatments including steroid injection and pressure therapy to reduce recurrence risk, while being honest that recurrence rates remain significant.
MR SAFWAT IBRAHIM
Scar Revision Surgery in Dublin
If you have a scar that is affecting your confidence or causing physical difficulty, contact Mr Ibrahim's rooms to arrange a consultation. He will examine the scar carefully, discuss your concerns, and give you a clear, realistic picture of what improvement is achievable and how best to approach it.