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Incision Scars

Every surgical procedure that requires a skin incision will invariably heal with a surgical scar. As surgeons we do our best to place incisions in inconspicuous sites or around the face. And sometimes we may be able to avoid external incisions altogether. Scars mature over a period of a year with the majority of the improvement occurring within the first 6 months. There are three types of abnormal scar patterns. Although most scars heal normally and leave a fine, flat line on the skin, there can be patterns of abnormal scarring that can form after a surgical procedure. The first type is an atrophic (depressed) scar. This scar leaves a depressed, usually white mark that is usually treated with excision and repair or possibly filler application underneath the depression. These types of scars do not respond to laser therapy or steroid injection. The second type is a hypertrophic scar, this type of scar is usually raised or heaped up and progresses over the first four to eight weeks after surgery. This type of scarring can be modulated by treatment with steroids and/or 5FU as well as laser therapy. The third one is keloid scarring which are massive heaped up scars (which some describe as hypertrophic scarring on steroids) this is the most uncommon type of scarring except in African American patients. Keloids occur rarely on the face except on the ear lobes and are commonly treated with steroid injections and/or excision and repair. 

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