Scar Revision in Marylebone, London

Initially the scar is likely to look discreet and neat, but after around 2 weeks it will become red and lumpy, which is a normal part of the healing process. Over 18-24 months, the revised scars will soften, becoming flatter and paler.

Your scar line will be protected by brown, showerproof micropore tape for the first 14 days after surgery. After showering, dry the tape with a hairdryer on a warm or medium setting to ensure it stays in place.

Once the tape has been removed, massage the healing scar with a moisturising cream (E45 is too viscous, but a simple vitamin E cream will suffice). Make this part of your daily routine and continue in it for 6-12 months for optimal results. Massage hastens the natural healing process and encourages scars to soften, flatten, and become paler.

Absolutely! If new scars are exposed to the sun they can become pigmented or retain permanent redness. Covering scars with clothing or sun protection factors (SPF50) protects the healing scar and helps deliver an optimal outcome. This needs to be undertaken diligently for about a year.

Hypertrophic scars are reddened, lumpy scars that continue to grow after the wound itself has healed. Hypertrophic scars are more likely if there has been a delay in the healing process, as can occur due to infection, or when the healing wound has been inadvertently reopened and left to heal without intervention. Hypertrophic scars occur most frequently on certain parts of the body such as the chest and shoulders.

Much like hypertrophic scars, keloid scars are enlarged, ridged, or lumpy scars that continue to develop long after the original wound has healed. Unlike hypertrophic scars, keloids can continue to grow beyond the surgical area or site of injury, becoming sizeable in some patients.

Although keloid scars can occur in anyone, they are most common in people of Afro-Caribbean or Far Eastern origin.

Hypertrophic and keloid scars can be difficult to treat. Mr Khoda will assess your scars to ascertain whether or not surgical removal of the scar and re-stitching of the wound might be effective. If the cause of the abnormal scar is infection delaying the healing process, this can be a successful approach as long as infection is avoided after the second surgery.

Other remedies for hypertrophic and keloid scars include:

• Silicone gel, applied as a liquid or sticky sheet to the scar.
• Steroid injections, placed directly into the scar. These need to be repeated every 6-8 weeks.
• Radiotherapy for specific keloid scars.

The success rates of the different treatments is variable, and depends on a variety of factors, including the cause of the scar in the first place. Mr Khoda will advise you on the best treatment option for your individual needs, including a combination of approaches.

All surgeries can lead to complications, but Mr Khoda works in a safe and consistent manner to minimise any risks. He uses the non-touch technique, avoiding skin contact with any part of the wound or any substance or surface that will come into contact with the wound, such as the inner surface of dressings. The most common complications with surgery are bleeding, haematomas, infection, numbness, alteration in nipple sensation, and the need to return to theatre for further procedures. Surgery also presents a risk of deep vein thrombosis and pulmonary embolism.