Most of the scars look harsh and coarse initially, it gets better as time goes by. Therefore, observation at least for 6 months is mandatory if there is no special complication noticed. If you have some troubles with the scar, consult to the plastic surgeon is essential. Decision to take surgery should be made after sufficient counseling about what you expect and can get from the surgery.
Keloid is the result of an overgrowth of dense fibrous tissue that usually develops after healing of a skin injury and often involves the anterior chest, ear lobe, and shoulder. It is usually reddish and thickened with hypertrophic growth over the margin of the wound. Intralesional steroid injection, silicon sheet, and compression can be tried. From time to time, surgery may be tried, but keloid can be worse with the surgery so it is recommended whether one should take surgery or not has to be determined by the plastic surgeon.
Hypertrophic scar is often confused with the keloid. Hypertrophic scar has distinct feature of growing within the wound or the incision line and good response to the treatment. If the hypertrophic scar is intractable with conservative treatment, surgery can reduce the cicatricial tissue and alter the direction of scar leading to invisible scar.
Loss of skin or soft tissue due to trauma or burn can cause scarring that may have influence on the adjacent muscle and tendon leading to the limitation of motion. Scar contracture is basically due to the insufficiency of skin, therefore skin graft or flap surgery may be indicated and tissue expander with expanded flap coverage in some selected cases can be tried.
From the point of cosmetic view, scar on the face other than hypertrophic scar or keloid is considered as the candidate for the scar revision surgery. One thing that should be kept in mind is that scar revision cannot get rid of the scar completely. Scar revision narrows the width of scar and alters the unfavorable direction of the scar that may help it to be seen less definitely.
Scar may seem to be worse during the postoperative 2nd to 6th month. However, improvement in the color and size of the scar can be noticed after 9 months. Timing of stitch out is up to the location. In face, stitch out is planned in 3 to 5 days after surgery, trunk and extremity are planned a few days later than that of face. Daily activity can be resumed following the stitch out. Prevention of recurrence is attempted with the taping or the application of silicon sheet on the operation site.