How Do Plastic Surgeons Fix Scars: A Step-by-Step Guide

by Ella

Scars are a natural part of the body’s healing process, but they can sometimes become a source of discomfort, both physical and emotional. Whether resulting from surgery, injury, or skin conditions, unsightly scars can affect one’s self-esteem and quality of life. Fortunately, plastic surgeons have an arsenal of techniques and procedures to help minimize and improve the appearance of scars. In this article, we’ll explore the innovative approaches plastic surgeons use to address scars and help patients regain their confidence and well-being.


How Do Plastic Surgeons Fix Scars?

1. Scar Assessment

Before any scar revision procedure, plastic surgeons conduct a thorough assessment of the scar. They evaluate its type, size, location, and its impact on the patient’s appearance and function. Scars can be categorized into different types, such as hypertrophic, keloid, atrophic, or contracture scars. This evaluation is essential in determining the most suitable approach for scar revision.


2. Topical Treatments

For mild scars, plastic surgeons may recommend topical treatments as a first step in the scar revision process. These treatments can include silicone-based gels or sheets, which help hydrate and flatten the scar tissue, ultimately reducing its appearance. Additionally, the use of topical corticosteroids can be effective in managing hypertrophic and keloid scars by reducing inflammation.


3. Laser Therapy

Laser therapy has revolutionized scar revision by offering a non-invasive solution to improve scar appearance. Various laser types, such as fractional lasers and pulsed dye lasers, are used to target and break down the scar tissue. This stimulates the body’s natural healing response and promotes collagen remodeling, resulting in a smoother and less visible scar. Laser therapy can be particularly effective for hypertrophic and keloid scars.


4. Micro-Needling

Micro-needling is a minimally invasive procedure that involves the use of fine needles to create tiny punctures in the skin’s surface. This process triggers the body’s healing response, promoting collagen production and breaking down scar tissue. Micro-needling can be an effective treatment for atrophic scars, such as those caused by acne or chickenpox.

5. Dermal Fillers

Dermal fillers are often used for atrophic scars to add volume and improve skin texture. By injecting a filler into the scar, plastic surgeons can lift and smooth out the depressed area, making the scar less noticeable. Common fillers used for scar revision include hyaluronic acid-based fillers.

6. Steroid Injections

Steroid injections are particularly effective for hypertrophic and keloid scars. By injecting corticosteroids into the scar tissue, plastic surgeons can reduce inflammation, redness, and itching. Steroid injections can also help flatten and soften raised scars, improving their appearance and comfort.

7. Surgical Scar Revision

In some cases, surgical scar revision may be necessary to achieve the best results. This approach is often used for scars resulting from surgery, injury, or traumatic accidents. Surgical scar revision involves removing the existing scar and carefully rejoining the skin in a way that minimizes tension and promotes optimal healing. The surgeon may use techniques such as W-plasty or Z-plasty to reposition and reshape the scar for improved cosmetic results.

8. Tissue Expansion

Tissue expansion is a unique surgical approach primarily used for patients with burn scars, large congenital nevi, or severe traumatic scars. This procedure involves placing an inflatable device beneath the skin near the scarred area. Over several weeks, the device is gradually filled with a sterile solution, stretching the surrounding healthy tissue. Once enough expansion has occurred, the plastic surgeon removes the scarred tissue and uses the expanded healthy tissue to cover the area. Tissue expansion allows for more extensive scar revision and better cosmetic outcomes.

9. Skin Grafting

In cases where a scar is extensive and lacks adequate surrounding tissue for closure, skin grafting may be the preferred technique. During a skin grafting procedure, the surgeon removes a piece of healthy skin from one area of the body and transplants it to the scar site. This method is especially beneficial for large burn scars or areas where skin is missing due to injury or surgery. Skin grafts help to improve both the function and appearance of the affected area.

10. Z-Plasty and W-Plasty

Z-plasty and W-plasty are advanced surgical techniques used to change the orientation of a scar and make it less noticeable. These techniques involve creating small, carefully designed incisions that create new lines and angles, effectively “breaking up” the scar. Z-plasty and W-plasty are especially useful for contracture scars, which often result from burns or skin loss.

11. Subcision

Subcision is a minimally invasive technique used to treat rolling or tethered scars caused by acne or trauma. During the procedure, the surgeon inserts a needle beneath the scar tissue and manually detaches it from the underlying tissue. This helps release the scar from the skin’s surface and allows it to lift, creating a smoother appearance.

12. Combining Approaches

Plastic surgeons often use a combination of techniques to address complex scars. For example, they may start with laser therapy to break down scar tissue and then follow up with a surgical procedure like Z-plasty to reposition the scar. Combining approaches can provide the most comprehensive and effective results.


Plastic surgeons have an array of techniques and approaches at their disposal to address scars, whether they result from surgery, injury, or skin conditions. The choice of method depends on the type of scar, its size, and its impact on the patient’s life. Scar revision procedures are not only about improving aesthetics but also enhancing a patient’s confidence and overall well-being. By using innovative methods and customized treatment plans, plastic surgeons play a crucial role in helping individuals move beyond the physical and emotional challenges posed by scars, allowing them to embrace life with renewed self-assurance.


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