Other Skin Procedures

Scar revision is a surgery employed to improve the appearance and feeling of a scar that has not healed in an ideal way. The type of scar that leads patients to seek scar revision may stem from any one of several factors:

• Traumatic injury, such as a dog bite, a deep cut, or a fall
• A prior surgery
• Hypertrophic scar development
• Keloid development

Note that scar revision to address hypertrophic scars deals with scars that have stayed within their initial borders, but grew wider and thicker than a typical scar. A keloid scar is considered pathologic and grows past the scar’s original borders.

These scars are sometimes associated with an itching, burning, and even painful sensation.

Scar revision involves Dr. Gowen excising the unwanted scar and closing the tissue in a layered fashion so that it heals with less of a noticeable line. A particularly tight scar or a burn scar might require scar revision in the form of a Z-plasty, which can loosen and change the direction of a scar by way of a flap, elongating or rotating it to make it less visible. This scar revision can also relieve tension that causes discomfort at the site of the scar.

Steroid injections are often used prior to or instead of a scar revision, since they can flatten and shrink hypertrophic or keloid scars.

Acne Scars

Severe, cystic acne breakouts often cause inflammation and damage to the inner layers of skin, leading to the formation of sunken scars when the collagen that is produced to fill them is insufficient.

An injury that will not heal on its own may require surgical wound care. Dr. Gowen and her team can provide basic guidance and care for patients suffering from this problem, whether due to trauma, prior surgeries, or vascular problems. Hygiene to prevent infection is key, and if possible, the wound can be closed to speed up the healing process.

One of the first rungs on the reconstructive ladder is skin grafting, a technique that facilitates closure and healing for wounds, burns, and regions where tumors have been removed. If the impacted area is too large to heal on its own, Dr. Gowen may take skin from a donor site elsewhere on the body to create a graft and encourage the skin to develop new blood vessels and provide protection and aesthetic benefit in its recipient site. She primarily uses tissue from the thigh, though grafts for the face could come from a crease in the neck or behind the ear.

Flap surgery is also used to close areas that wouldn’t otherwise heal. Muscle or musculocutaneous flaps may help with knee replacement wounds, for instance, or in soft tissues where tumors have been removed, such as the breast. Similar to skin grafting, tissue is moved from a donor site to a recipient site, but in this case, blood vessels are preserved and transported with the tissue.

Small flaps are also often used in MOHS reconstruction, where cancerous tissue has been removed on the face.

This is frequently a required biopsy in melanoma diagnoses. Lymph nodes are taken for pathological examination as required in suspected cases of skin cancer that meet certain staging criteria. More about this procedure can be explained in a consultation.

Patients whose scar revision or other skin health and aesthetic needs do not require surgery can talk with their doctors about less invasive options, including dermal fillers and laser skin resurfacing.