Scar revision

A visible scar on the face or body does not only mark the skin: it can undermine self-confidence and recall a traumatic event. With advanced maxillofacial and plastic surgery techniques, an unsightly scar can be softened, reoriented and harmonised so that it becomes discreet again.

Every surgical incision or wound leaves a permanent mark. The aim of a revision is not to erase the scar by magic, but to transform it so that it blends harmoniously into the natural creases and tension lines of the skin (Langer’s lines).

The protocol, step by step.

1. Step 1

   Consultation and personalised diagnosis

   Analysis of tissue maturity, skin type and scar relief to define the strategy: surgical, device-based or combined.

2. Step 2

   Informed consent

   A full document setting out the expected benefits, the stages of the protocol, the expected recovery (redness, swelling, possible time off depending on the intensity of the laser or radiofrequency) and the biological limits of each skin type.

3. Step 3

   Treatment

   Performed at the practice under local or topical anaesthesia, with maximum technical safety.

4. Step 4

   Follow-up and tissue maturation

   Careful follow-up over several months to guide collagen remodelling.

Main indications

• Hypertrophic or keloid scars (thick, raised, red).

• Contracted or tethered scars limiting movement.

• Widened, sunken or pigmented marks after an injury or previous surgery.

• Irregular contours and facial asymmetry.

Dr Yousefpour’s treatment options: surgery and advanced technology

Every skin heals differently. The protocol is tailored, combining surgical techniques with the latest thermo-mechanical technology. Dr Yousefpour’s expertise in facial and tissue anatomy allows the treatment to be precisely adapted to the nature of the lesion.

• Local plasties (Z-plasty, W-plasty): reorienting the tension vectors to break up an overly visible straight line and blend it into the anatomical contours.

• Precision excision and closure: careful removal of the fibrous edges and layered closure with microsurgical materials.

• Fractional CO2 laser (precise ablative resurfacing): controlled removal of irregular surface layers and creation of thermal micro-channels; smoothing of the scar edges, evening of skin texture and stimulation of epidermal renewal.

• Morpheus8 (fractional microneedling radiofrequency): deep subdermal remodelling, with energy delivered directly into the dermis; breaking up of dense scar fibres and intense new collagen formation to fill sunken scars and tighten surrounding tissue.

• Adjunct treatments: targeted injections (corticosteroids to settle inflammatory components), compressive silicone dressings and topical healing protocols.

Which method to choose?

• Surgery (plasties), realignment and tissue excision: ideal for wide, contracted or poorly oriented scars.

• CO2 laser, controlled ablative resurfacing: ideal for surface irregularities, skin relief and texture.

• Morpheus8, deep fractional radiofrequency: ideal for sunken (atrophic) scars, laxity and dermal remodelling.

Dr Yousefpour’s recommendation

Remodelling a scar is an active biological process taking 6 to 18 months. Total sun protection (SPF 50+) and careful aftercare are essential for an optimal, lasting result.

Frequently asked questions

• Are these treatments painful? Surgery and CO2 laser are performed under local anaesthesia or with an anaesthetic cream applied an hour before: the procedure is painless, with a temporary “sunburn” feeling for a few hours. For Morpheus8, topical anaesthesia and adjusted settings ensure optimal comfort; a slight prickling and warmth is felt with each pulse.

• How many sessions are needed? One operation is usually enough for a surgical revision, sometimes complemented later by laser sessions. For CO2 laser and Morpheus8, a protocol of 2 to 4 sessions 4 to 6 weeks apart allows gradual, lasting collagen renewal, depending on the depth and age of the scar.

• Will I need time off? CO2 laser: 4 to 7 days (redness, mild swelling and fine micro-crusts that fade). Morpheus8: 24 to 48 hours (diffuse redness and mild swelling, easy to cover after 24 hours). Surgery: fine stitches removed after 5 to 7 days.

• When should a recent scar be treated? For surgical revision, it is often better to wait for the initial maturation of the tissue (at least 6 to 12 months). Light fractional CO2 laser or radiofrequency can be considered earlier, once surface healing is complete, to guide regeneration favourably.

• What precautions after a session? Avoid direct sun and apply SPF 50+ daily for at least 3 months; do not pick the small crusts and apply the prescribed healing cream; avoid saunas, steam rooms and strenuous sport for 48 to 72 hours.

Medical information: surgical scar revision

The operation surgically corrects an unsightly, widened, contracted or poorly oriented scar (direct excision and closure, local Z- or W-plasties, undermining and realignment along the natural tension lines of the skin). Essential information: surgery cannot make a scar disappear without a trace; its aim is to replace an abnormal or unsightly scar with a new one that is finer, more discreet and better hidden.

• Anaesthesia: local alone or local with sedation.

• Procedure: removal of the fibrous tissue and careful closure in several deep and superficial layers with microsurgical materials.

• Stitch removal: between the 5th and 10th day after surgery, depending on the area.

Usual recovery and patient commitments

• Swelling, bruising and a feeling of skin tightness for a few days.

• Normal inflammatory phase with redness of the new scar for 2 to 3 months; full maturation over 12 to 18 months.

• Silicone dressings or scar massage as prescribed.

• Strict sun protection (SPF 50+) for at least 1 year to avoid hyperpigmentation.

• Stopping smoking is strongly recommended to optimise microcirculation and healing.

Possible risks and complications

Although rare with careful technique, the following risks exist:

• Haematoma, bleeding or local infection requiring suitable treatment.

• Wound breakdown or delayed healing.

• Temporary or permanent change in local skin sensation.

• Recurrence of a hypertrophic or keloid scar due to the patient’s own biological reaction.

• Residual asymmetry or the need for a further procedure later (laser, touch-up).

Informed consent

You receive an informed consent form before the operation. By signing it, you confirm that Dr Yousefpour has given you clear, honest and understandable information about the surgical revision of your scar, that you have been able to ask all your questions and have had enough time to reflect.