Over this past week, I have witnessed several traumatic injuries to the face while watching a number of competitive water polo games in Orange County. Many of these injuries occurred around the eyes and forehead region and involved lacerations (cuts). Unfortunately, I was not equipped to offer my services on the pool deck! Most of these injuries were subsequently seen and treated in the local emergency rooms. Although there is great care provided in a good majority of our community emergency rooms, facial laceration repair is one procedure that commonly needs revision by a plastic surgeon. This is a great example of facial scar revision in a female patient from San Diego, CA who was also initially repaired in an emergency room. 
This particular patient suffered a facial laceration while sledding in the local mountains. The laceration was repaired by staff at a local emergency room without the advise of a plastic surgeon. Unfortunately, the laceration did not heal optimally and she desired scar revision to make it less visible. As you can see in the adjacent photo of her forehead, there is an obvious visible scar that is abnormally shaped running across her mid-forehead. You can also appreciate the fact that the scar has darkened (called hyperpigmentation) and is slightly depressed (sunken in). This latter problem creates unwanted shadowing of the scar and contributes to the scar being much more visible.
The patient elected to undergo facial scar revision with our office to help improve the appearance of the scar. We recommended a technique called excisional scar revision – meaning we planned on cutting out (excising) her old scar and redoing the closure in a more meticulous manner. She underwent the procedure using just local anesthesia to numb the area. We removed her old scar completely then realigned the skin edges in a very strategic fashion. We then let her heal for at least a year, which is about how long it normally takes for scars to mature and evolve to a stable state. In the meantime, she was recommended to use topical healing gels like Mederma and silicone to aid the scar maturation process. Her end results are shown below.
Photos of Facial Scar Revision
As you can see from her before and after scar revision photos, she has a significant improvement in the appearance of the scar. Is it completely invisible? Absolutely not. But the patient and plastic surgeon have to be realistic in terms of what they are trying to achieve with this type of cosmetic enhancement procedure. The goal is to make the scar less visible to the naked eye. It would be completely unrealistic to think that the scar will disappear completely after scar revision. In this particular case, we were able to achieve the goal of making the scar much less visible to the naked eye. The level of the scar is much better and more even with the surrounding skin. The texture and color of the scar have also been enhanced. There has been a clear cosmetic improvement that might be further enhanced by additional techniques like dermabrasion. However, the patient is quite happy with the overall change and is not interested in pursuing any further procedures for the scar. If you are interested in having a scar revised for cosmetic improvement in appearance, please do not hesitate in contacting our San Diego facial plastic surgery office today.
