It is difficult to predict the extent of scars that develop after various accidents and surgeries. The size of the potential scar is determined by the skill of the surgeon as well as the patient’s individual characteristics.
Many factors have an effect on scar development. The size and depth of the wound, whether or not the injury site is well-blood-supplied, color and thickness of the skin, and the location of the wound in the body have an effect on the size of the scar.
Although it is not possible to remove scars completely, they can be reduced and made less noticeable by means of plastic surgery procedures. For this purpose, cortisone, silicone applications or various surgical procedures can be utilized.
An important part of the scars, which are initially more noticeable, becomes less noticeable and less disturbing in the course of time. At least six months are required to pass after the injury or surgery, for the wound and scar to mature and take their final shapes. This period of time needs to pass, for the ability to decide on whether the scar is suitable for surgical intervention.
KELOID SCARS
Keloids are red, swollen, and itchy scars, which may have wrinkles on their surfaces and may exceed the boundaries of the wound. They develop as a result of the condition in which new cells and tissues produced by the body for healing a wound continue to be produced uncontrollably after the healing of the wound.
Although keloids can be seen in any part of the body, they are mostly seen in the mid-line area of the chest, ear-lobes and shoulders. It is more common in dark-skinned people. Its probability of occurrence is higher in young people compared to elderly people.
Cortisone injection is the first treatment to be applied to keloids. Surgical procedures can be applied in case of keloids that cannot be reduced with this treatment. These surgeries are usually done under local anesthesia. Rarely, skin grafts or tissue expanders are required to be used for the treatment of major scars.
HYPERTROPHIC SCARRING (Extremely Large Scar)
Hypertrophic scars and keloids may often be mistaken for each other. Although their appearances are similar, hypertrophic scar does not exceed the limit of the wound. Its risk of recurrence after treatment is higher than that of keloid. In its treatment, procedures similar to the ones used for the treatment of keloids are performed.
CONTRACTURE (Limitation of Movement Ability due to Scars)
Scars emerging after large tissue losses that occur in consequence of some burns and traumas may cause limitation of movement ability. In medicine, this is called ‘contracture’. Contractures that may cause limitation of movement ability mostly develop in certain regions such as the neck, and hand. Such contractures can be treated by changing their directions or by means of various tissue transplantations.
SCARS FORMED BY RAZOR BLADES OR OTHER SHARP OBJECTS
There may be scars made by individuals on their own bodies (mostly in the arm and the chest area) during various stressful periods and due to psychological depressions. For those people, the meaning of the scars is more important than the aesthetic problem caused by the scars. Patients want to get rid of the meaning of the scar, rather than its appearance. For this purpose, scars can be reduced; their directions can be changed to enable them to look like surgical scars, or can be completely eliminated with certain procedures such as graft use. It is possible to remove tattoos, as well, by using the same procedures.
TREATMENT with TISSUE TRANSPLANTATION (grafts or flaps)
Procedures that involve the transplantation of tissues called flap or graft may be required to be used for the treatment of large scars. These are surgical operations required to be done under general anesthesia in hospital conditions.
Graft refers to a surgical procedure that involves the transplantation of a piece of skin, taken from another part of the body, to an open wound. The transplanted tissue lives in its new place by means of the blood vessels developing there.
Flap refers to a surgical procedure that involves the tissue transplantation that may include also fat tissue, muscles, and blood vessels besides a piece of skin. Some of these transplantation procedures are carried out by protecting the blood vessels of the transplanted tissue, while some others provide blood supply from the blood vessels at the site of transplantation by using microsurgical methods.