Before and after abdominal scar revision in a 68 year old woman. In her 20’s she had emergency appendix removal through a long incision that had formed a deformed, depressed scar. She was scheduled for another Plastic Surgery procedure and asked if her scar could be improved at the same time. The answer was YES!
Scar revision involves surgical excision of the old scar and freeing the surrounding tissue (skin and fat layers) from tight scar bands. It involves ensuring all the layers of the abdominal wall (skin, dermis, superficial and deep layers of fat and the fascia (connective tissue layer) between them are closed to their respective partner layer on the other side.
To picture this, envision the abdominal wall as a three-layered cake. In most Plastic Surgery wound closures (like a tummy tuck), all three layers are closed to their respective partner layer on the other side: the bottom layer to the other bottom layer, the middle to the middle, and the top to the top layer.
In the instance of depressed scars like this one, picture that “the cake icing has healed stuck down to the bottom of the pan”. Often (in non-Plastic Surgery procedures), only the deepest layer of fascia and the skin are closed, and the scar is depressed and stuck to the deepest layer of fascia.
Scar revision in this case created a much better looking scar and corrected the depression resulting from scar bands pulling the normal layers of fat downward. Each layer of the abdominal wall was repaired to its partner on the other side, and a flush, flat, smooth incision results, which is always our goal in Plastic Surgery!
*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.
