Facial scars can be removed permanently

1. What is the role of plastic surgeon in the management of facial scars?

The face is a very important organ to the human being. It becomes more and more important with the development of the social status of a country. The face is the main organ involved with the social relationships and it contributes a lot to one’s personality.

There is an increasing enthusiasm on the erasing the facial scars and the improvement in the facial aesthetics. The plastic surgeons around the world involves in the management of facial scars and aesthetics. Their training in the delicate surgery helps in achieving better outcome from the various procedures.

2. Can the plastic surgical procedures erase a scar?

In fact this is the expectation of the patient all the time and it is our endeavour too. However there are limitations in some cases. Honestly we cannot erase a scar as it could be done in an actor by wiping off the make up made to pretend a scar. However, we can make a scar minimally sighted.

As you know we have facial creases. These creases are very visible in an old face. If the scars lie in parallel to the facial creases the appearance of the scar would be more pleasing and minimally visible at a distance which humans maintain during the social relationships.

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2. Are there different types of scars?

Briefly there are two types Hypertrophic scars which means a growing up scar and an Atrophic scar which means of a failure of normal healing.

Hypertrophic scars – In some patients the facial wound could become angry during the healing process and the scar becomes prominent and protruding above the level of the normal skin. Usually these scars are annoying and aesthetically poor.

Atrophic scars –  These are flat and stretched scars. They usually result in poor repair of the facial injuries. The face has got a muscle layer under the skin which helps in the facial expressions. When there is deep injury of the face involving the muscle layer it should be repaired carefully and if not the wound healing may not be appropriate and scar will stretch.

4. How do you manage these different types of scars?

The hypertrophic scars can be prevented by applications of a gel at initial stages. But when it is established may need surgical removal and follow the scar therapy. Some of the hypertrophic scars may respond to steroid injections. But it may be very painful to inject steroids to facial scars.

The atrophic scars need a redo repair of the facial injury and the applications of the creams are not going to be helpful. If the facial injury lies parallel to the facial creases the outcome would be great. Anyway after a proper repair of a atrophic scar one has to follow scar therapy protocols.

5. Do you have any secrets in achieving better results in plastic surgery?

Well people think plastic surgeons are having secrets in achieving results. It is not unreasonable also to think like that. Anyway it is the delicate handling of the human tissues and attention to detail gives the best outcomes.

6. What techniques are available to improve the facial appearance?

There is an increasing enthusiasm on the improvement of the facial appearance among the women especially. The skin colour of the face is of primary concern. Many patients request some treatment to become fair. There are several treatments available in achieving a fair skin. However it is important to understand getting an even pigmentation is the most important thing as per the facial aesthetics are concerned.

There are injections ( Glutathione) available which will destroy the melanin in our skin cells and are not recommended by the drugs authorities. These injections are being used for melanin destruction to relieve symptoms of melanoma ( skin cancer) which has spread all over the body. The use of these injections in healthy humans who want to have a better appearance could give harmful results and death may result.

Anyway there are drugs which can be used carefully to have a fair and evenly pigmented skin of the face. Use of a sunscreen is very important in a country like ours as the number one enemy of the facial skin is the sunburn.

In addition, there are chemical peels and laser techniques which can improve the appearance of the face.

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Dr. A. Shashanka Rathnayake  

Consultant Plastic & Reconstructive Surgeon

Teaching Hospital – Kandy