Scars are the marks that are left on the skin after an injury is healed. Scars can be caused by trauma, cuts, burns, acne, and skin related diseases like vitiligo or chickenpox. Scars are thicker, and shinier than normal skin and can appear anywhere on the body. They are usually red or pink in colour. Scars do not immediately disappear but fade in time.
Plastic surgeons are skilled at hiding scars. No surgeon can make a scar disappear.
- Keloid scar: these are thick, raised and are often red or dark in colour. They are caused by the over production of collagen that grows beyond the wound.
- Hypertrophic scars: these are also thick, red, and are raised. But unlike keloid scars they do not grow over the wound but instead remain within their boundary.
- Contractures: This occurs when the elastic nature of the skin is replaced with fibres which make the skin more rigid losing the ability to stretch and restricting movement. This can occur with burns or with the loss of a large area of skin from injury.
Z-plasty is performed for scar revision and is useful with contracted scars.
Z-plasty is a technique which redistributes tension on the wound by breaking up the scar into smaller units, making the scar less noticeable. In this technique, two flaps of the skin are replaced with a limb. These limbs arrange themselves to look like a ‘Z’.
W-plasty is performed on scars that are triangular in shape. W-plasty does not add any extension or length to the scar, but decreases the lateral tension of the scar.
Dermabrasion can also be used to blend scar tissue. This involves the use of a high speed diamond tipped burr and is performed as a day surgery procedure. Dermabrasion leaves a raw area over the skin for a week and will require scar treatment and sunscreen for 6 months following.
Z- and W- plasty surgical techniques give a geometrical impression of the scar on the skin making the scar less noticeable and more natural.