While silicone is recommended as a safe and effective option for treatment and prevention of hypertrophic and keloid scars, surgery might be the only option for certain scars. In particular this might be the case for patients with hypertrophic scars from complicated wounds or delayed closure.

There are two possible reasons for excision:

  1. Surgical excision of the scar brings the new excision within the relaxed skin tension lines which ultimately improves healing, stating this is ideal in patients with hypertrophic scars crossing joints or wrinkle creases at a right angle, and
  2. Excision causes scar disruption making the lesion less conspicuous.  Most surgeons acknowledge that surgery in case of keloid often makes the situation worse by stimulating additional collagen synthesis. Simple excision of keloids has been associated with up to an 80% recurrence rate. Thus surgery should be used in conjunction with other modalities when treating keloids, if used at all.

Even with surgery, however, the scar will not be completely erased. Surgery can provide a better cosmetic result or help with a scar that has healed poorly.

For more information about scar revision surgery visit the web site of American Society of Plastic Surgeons. And, after you surgery, be sure to use Strataderm; silicone gel is the only noninvasive option for which evidence-based recommendations have been made for both scar treatment and prevention by leading specialists worldwide. A clinical trial published in 2007 found only 7% of patients who were treated with silicone gel developed scarring compared with 26 % receiving no treatment.

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