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Contemporary Review | Journal Club

Scar Revision Review

J. Regan Thomas, MD; Michael Somenek, MD
Arch Facial Plast Surg. 2012;14(3):162-174. doi:10.1001/archfacial.2012.223.
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Published online

Scars are a natural part of dermal healing following lacerations, incisions, or tissue loss. They can vary in quality depending on the individual's racial characteristics, the mechanism of the trauma, and conditions in which the wound healed—all of which are factors beyond the surgeon's control. A scar on the face can have significant implications for the patient. What may seem like an insignificant issue to the casual observer can cause continuous frustration for the patient, affecting their daily lives. These can include psychological as well as social consequences, leading to a diminished quality of life. Factors that the surgeon can control include the favorable repositioning of the scar, proper alignment of the wound edges, and meticulous handling of the tissues.

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Figure 1. A, An earlobe keloid scar from ear piercing; B, earlobe 1 year following excision, serial steroid injections, and local pressure to the site.

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Figure 2. A, Distortion of the lower ear from keloid formation; B, appearance of lower ear following excision and reconstruction, serial steroid injections, and local pressure.

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Figure 3. A, A keloid scar of left cheek; B, appearance of scar following excision, serial corticosteroid injections, and silicone gel sheet application.

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Figure 4. A, Recurrent keloid scar formation in the post auricular area; B, appearance following surgical resection and serial low dose radiation therapy.

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Figure 5. A, A widened, elevated scar of the upper lip; B, scar appearance following fusiform excision and dermabrasion.

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Figure 6. A, A trapdoor scar of the right cheek region; B, the appearance following multiple Z-plasty.

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Figure 7. A, A widened forehead scar; B, intraoperative excision and closure with running W-plasty; and C, final appearance at 6 months following W-plasty and dermabrasion.

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Figure 8. Typical diamond fraises used in dermabrasion.

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Figure 9. A, An acne scar of the nasal tip; B, following dermabrasion of the nasal tip scar.

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Figure 10. A, Multiple forehead scars; B, the appearance 6 months following dermabrasion.

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