Choosing to have a scar revised is a matter of personal choice. Some of the variables that affect scarring include:

  • The cause of the original injury
  • How your body heals
  • The size of the scar
  • The depth of the scar
  • The blood supply to the scarred area
  • The thickness and color of your skin
  • The direction of the scar with respect to the natural lines in the skin

While no scar can be removed completely, the appearance of a scar can be improved to make it less obvious through the injection or application of certain steroid medications or through surgical scar revisions. Many scars that appear large and unattractive at first may become less noticeable with time so waiting as long as a year or more after an injury or surgery before you decide to have scar revision is advisable. Scar revisions can be done under local anesthesia or general anesthesia depending on the extent of the scar.

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Keloid Scars Vs. hypertrophic Scars

Keloid Scars

Keloids are darker, red, thick, puckered, itchy clusters of scar tissue that grow beyond the edges of the wound or incision. Keloids occur when the body continues produces excess collagen after a wound has healed. Keloids are most common over the breastbone, on the earlobes, and on the shoulders but can appear anywhere on the body. Occurring more often in dark-skinned people than in those who are fair, the tendency to develop keloids lessens with age.

Keloids can be treated by injecting a steroid medication directly into the scar tissue to reduce redness, itching, and burning and also shrink the scar. If steroid treatment does not help, the scar tissue can be cut out and the wound re-closed. Occasionally a low-dose, 3-day course of radiation therapy +/- steroid injection is used to treat the keloid immediately after surgical excision.

Keloids have a tendency to recur, in some patients even larger than before, requiring repeated procedures every few years.

Hypertrophic Scars

Hypertrophic scars can often be confused with keloids because both tend to be thick, red, and raised. Hypertrophic scars differ from keloid scars because they remain within the boundaries of the original incision or wound and they often improve on their own over time or with the help of steroid applications or injections.

If time and steroids are not effective, hypertrophic scars can often be improved surgically.


A process called contraction occurs when burns or other injuries result in the loss of a large area of skin that forms a scar that pulls the edges of the skin together. The adjacent muscles and tendons can be affected causing restriction of normal movement as a result of the contracture.

Correction of a contracture usually involves removing the scarred area and replacing it with a skin graft or a flap. In some cases, a Z-plasty revision or tissue expander may be needed to release the scar and provide healthy unscarred tissue to the area. Physical therapy is sometimes needed to restore function to an area that has had a contracture for a long time.

After Care

Dr. Granzow takes time to know each patient that comes to his practice. After you scar revision, Dr. Granzow may have you use a silicone gel or sheet to help compress and flatten the scar.

For more information on scar revision, contact our office to schedule a consultation with Dr. Granzow at (310) 882.6261.