Facial scars can be emotionally disturbing to the person who has them. Elongated, reddened, elevated, depressed or distorted scars may be particularly unsightly and attract attention away from more important facial features. Many of these may be markedly improved by carefully designed and skillfully executed surgery. Before proceeding, the patient must understand certain facts. 

Chickenpox scars or facial acne scars are best treated either with laser or dermabrasion and sometimes may require mini-grafting for optimal results (see the laser and dermabrasion sections). 

The scar improvement procedure is just that, scar improvement; the exchange of an unsightly bad scar for a better scar. The new incision heals in the same fashion as any other incision, with the final result dependent upon the patient's healing ability. 

The surgeon makes every effort to blend the newly placed incision into the surrounding tissues. By blending the surgical scar in or parallel to the normal creases of the face, the new scar may be more easily hidden. Occasionally, more than one procedure or skin grafting may be necessary. Finally, dermabrasion may provide the finishing touches for optimal results. 

Immediately following surgery, very little discomfort is typically experienced, with the patient able to return to school or work the next day. Usually, the area is camouflaged with flesh-colored tape. 

Dermabrasiontop

Chickenpox, acne and trauma may cause unsightly scars with a series of skin elevations and depressions. Improvement in this appearance is achievable by smoothing the skin and "leveling" the elevations. This is best achieved by dermabrasion with a delicately controlled rotating brush. Improvement is the goal, not perfection. The finest results are achieved with repeated procedures. Ultimately, residual scarring is concealable with make-up. 
 

Before

After Nasal Dermabrasion

The Procedure

With sedation and the skin anesthetized, the skin is dermabraded and a special soothing dressing applied for forty eight hours. Pain is easily controlled. After the procedure, swelling, crusting and redness are expected to worsen initially. Most of the swelling and crusting is gone after one week, with the redness continuing for some time thereafter. The patient must avoid sunlight for one month before and three to six months after surgery to prevent hyperpigmentation. Pink skin is concealable with light makeup. Scarring, pigmentation, milia (small projections or lesions), and prolonged redness are possible complications, but fortunately not common. Repeating the procedure at three month intervals is advisable to optimize results. 

The Healing Process 

Any operated area undergoes a maturation process over the follow ing months to years. Initially, the scar appears slightly raised above the skin surface. Over the following weeks, the scar becomes reddened and lumpy with a hard consistency. Once the scar proceeds through this natural process, it softens, flattens, and becomes paler than the surrounding skin. 

Healing of any scar, including a planned scar, takes time. Scarring as a result of an accident heals over the same period of time. Before scar improvement can be planned, a scar must be on its way to maturity. Sometimes, the healing process produces results that require no further treatment. 

Certain types of scars are best treated prior to full maturity. A variety of techniques may be used to provide the most favorable result. It is most important to remember that a scar will always remain, but will appear less visible.