It is important to know that scars never actually disappear and that all surgical techniques leave a scar. One can anticipate to an extent whether a surgical scar will be visible or not if they consider the following:
- Scars that run vertically to the body in a certain region will be visible.
- Some parts of the body are prone to hypertrophic scars, such as the shoulder or the chest, while in other parts, the scars are small and not very visible, such as the eyelids or the ears. Increased tension in an incision will produce a wide scar. The younger the patient is, the more evident the scar, while sagging skin does not produce many scars. The patient’s medical history with regard to hypertrophic scars and keloids must be taken into account. Care must be taken so that surgical incisions are performed in well-hidden areas , e.g. behind the ears, inside the nose, in the scalp, etc.
- Hypertophic scars and scar shrinkage from injuries or burns must be treated based on these principles. The removal of a scar usually leaves a depression on the skin. Provided the surgeon anticipates this, they will place a tissue expander beforehand to create extra skin. The tissue expander is a silicone balloon that is placed under the skin and is gradually expanded over 2-3 months with the injection of saline. When it is removed, enough excess skin has been created to cover the depression left by the removed scar. If a scar is modified using Z-plasty techniques so that it may be placed along the lines of the body, it will become longer but less discernible.