What is Scar Revision?
Scar revision is an umbrella term for a range of procedures — surgical and non-surgical — designed to improve the appearance of scars that are unsatisfactory in terms of size, colour, texture, or position. No scar can be erased completely, but with the right technique applied at the right time, a scar can be made significantly less visible — blending more naturally with the surrounding skin, lying flat rather than raised, or being repositioned into a less conspicuous location. At Panache in Delhi, Dr. Ankit Gupta assesses each scar individually. The type of scar, its age, location, cause, and the patient's skin type all influence which technique will deliver the best improvement. A personalised treatment plan is always designed after thorough evaluation.
Types of Scars We Treat
Different scars require different approaches. Understanding the scar type is the first step in planning effective revision.
- Hypertrophic scars — raised, red, firm scars that remain within the original wound boundary; often caused by tension or inflammation during healing
- Keloid scars — raised scars that grow beyond the original wound boundary; more common in darker skin tones and on the chest, shoulders, and earlobes
- Depressed (atrophic) scars — sunken scars, typically from acne, chickenpox, or surgery where tissue was lost
- Contracture scars — tight, restrictive scars following burns or injuries that limit movement
- Widened or stretched scars — flat but wide scars, often from surgical incisions placed under tension
- Poorly placed scars — scars in visible or aesthetically sensitive locations (face, neck, décolletage) that can be repositioned
- Post-surgical scars — scars from previous operations that healed suboptimally
Treatment Techniques
Dr. Ankit selects the most appropriate technique based on the scar's characteristics, location, and how long it has been present.
- Surgical excision & re-closure — the scar is excised and the wound is re-closed with meticulous layered suturing under minimal tension. Often dramatically improves wide or irregular scars.
- Z-plasty / W-plasty — geometric techniques that reorient a scar into the natural skin creases (RSTL) to make it less conspicuous and relieve tension contractures
- Steroid injections — corticosteroid injections into hypertrophic or keloid scars to flatten and soften raised tissue. Typically 3–6 sessions at monthly intervals.
- Laser resurfacing — fractional CO2 or Er:YAG laser to improve scar texture, colour, and surface irregularity
- Microneedling with your own growth factors — stimulates collagen remodelling in atrophic (sunken) scars
- Silicone sheets / gel — non-invasive maintenance for flat, mature scars to soften and fade them further
- Filler injection — for depressed scars, filler can be used to elevate the scar to the level of surrounding skin
When to Have Scar Revision',
Timing is one of the most important factors in scar revision. Intervening too early — before a scar has matured — can produce a worse result than waiting.
- Most scars should be allowed to mature for at least 12 months before surgical revision
- Steroid injections can begin earlier — within 6–8 weeks of formation — for hypertrophic or keloid scars
- Laser treatments can begin once the scar is no longer pink/red and has stabilised (typically 6–12 months)
- Keloid scars often require a combination approach and longer follow-up to prevent recurrence
- Post-acne and chickenpox scars are generally treated once active acne is controlled
Aftercare
Aftercare is as important as the procedure itself — how a scar heals after revision determines much of the final outcome.
- Sun protection (SPF 50+) on all treated scars — UV exposure causes scars to darken and delays maturation
- Silicone gel or sheets applied daily for 3–6 months after surgical revision
- Avoid tension on the scar — no heavy lifting or stretching of the area during healing
- Moisturise the scar daily once healed to maintain suppleness
- Follow-up appointments to monitor healing and adjust treatment if needed
