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Facial Scar Revision in San Francisco

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    “Today I was asked a number of questions and I thought I’d just give a brief summary on how we manage scars, and really it’s quite simple how we break them down because scars are in different shapes and sizes and locations and how we treat them varies according to a number of different factors. But really there are about 4 or 5 things that makes scars noticeable and we can address each of those individually or collectively to make a scar virtually invisible.

    Anyone that tells you there's some kind of special eraser of scars or that the wound can heal without scaring, except in VIU surgery, has given you misleading information. Let's put it that way, but we can make scars very difficult to detect, almost invisible if they’re done correctly.

    The main reason that scars are visible are when the scars are not aligned evenly, in other words one side is higher than the other or the scar itself is depressed on the surface or elevated on the surface where the scars overgrown or hypertrophic. So the alignment or the height or depression of the scar is one factor that we think is obviously very important and it should be very smooth.

    The width of the scar, how far apart the two edges of skin are that have normal skin coloration because scars themselves don’t make color they're relatively hypo-pigmented or lighter than the surrounding skin and we'd like to see any scar especially on the face, be less than a millimeter. So a tiny little hairline scar and very well disguised in a special place on the face is what we're looking for whenever we're doing, whenever we're doing a treatments whether it's treating a skin lesion or something we don’t want or doing elective surgery.

    So again the height or the elevation of the scar, the width of the scar are very important factors and the third one which I’ve sort of eluded to already is the color of the scars. Scars typically don’t have the same color as the surrounding skin. In most patients the scar will be slightly lighter and some patients especially in patients that have olive or darker complex the scar itself might hyper-pigment which means it’s darker than the surrounding skin.

    Now hyper-pigmentation of scars is something we can treat with certain creams and other treatment to lighten the scars so it more adequately blends with the skin itself and so that should be as big of an issue but when we have a combination of a hypo-pigmented or lighter scar and one that's wide, it's something that we commonly want to treat to make it much narrow or and have a better color match to the surrounding skin.

    The other things that makes scars noticeable which would be intuitively obvious is where they are located. It's a big difference to have a scar for example the crosses the nasolabial fold this crease between the cheek in your mouth diagonally rather than a scar that follows right along the fold and often at times again when we're designing ways of treating skin cancers and other lesions or even doing cosmetic surgery or hiding the incisions for whatever treatment we are doing along a special crease or non-atomic boundary. Good anatomic boundaries along the face or at the sides of the nose or the ala at the nasal labial fold as mentioned and along the edges, the hairline, areas where there's a corner or triangle or good places to hide scars or disguise them. So the location of the scar, particularly on a facial prominent, like the cheeks, middle of the forehead where it's vertical rather than horizontal, these are areas where that the position again of the scar are very important.

    So we've talked about the height or the alignment of the scar, we talked about the width of the scar how far apart it, the scar would be. We've talked about the color of the scar, does it match or does not match the surrounding skin and of course we've talked about the position in general of the scar on the face and last one which it sort of goes together with the other is the general direction of the scar. I mentioned that to you before it could be in a good location but if its direction is bad there are techniques we can do when we treat with scar revision that can actually change the direction of the scar and make it much less noticeable.

    One other basic principle about treating a scars is that the eye, the human eye has ability to pick up things that are in line so when scars are very straight line in a prominent area on the face for example, there are treatments to help make that scar not so straight to break up the straightness of it, geometric broken line, z-plasty, or running w-plasty procedures are options that we use to make a scar not so straight not so regular and make it much more difficult for the human eye detect. So with all those things in play there are a number of different options that we have to treat a scar and make it much less noticeable if not quite invisible but pretty nearly invisible in the average patient and it's definitely worth it if you have a scar that you have somewhere on your body that you don’t like to have it checked out.

    I'm very happy to answer any questions, review photographs or video that you may take of your scars and I think you really do have a good opportunity to make unfavorable scars look much better if we address the basic principles about what makes a scar noticeable. Again if you have any questions or you can go to our website at, direct dialog even on or follow me on twitter at DrCoreyMaas. As always it's my pleasure Dr. Corey Maas on Looking Your Best.”