Last updated: 11/24/2009

Preparation for scar revision surgery includes the surgeon's assessment of the patient's psychological stability as well as the type and extent of potential scar tissue. Many patients respond to scarring following trauma with intense anger, particularly...

if the face is disfigured or their livelihood is related to their appearance. Some people are impatient to have the scars treated as quickly as possible, and may have the idea that revision surgery will restore their skin to its original condition. During the initial interview, the surgeon must explain that scar revision may take months or years to complete; that some techniques essentially replace one scar with another, rather than remove all scar tissue; and that it is difficult to predict the final results in advance. Most plastic surgeons recommend waiting at least six months, preferably a full year, for a new scar to complete the maturation phase of development. Many scars will begin to fade during this period of time, and others may respond to more conservative forms of treatment.

Good candidates for scar revision surgery are people who have a realistic understanding of its risks as well as its benefits, and equally realistic expectations of its potential outcomes. On the other hand, the following are considered psychological warning signs:

• The patient is considering scar revision surgery to please someone else—most often a spouse or partner.
• The patient has a history of multiple cosmetic procedures and/or complaints about previous surgeons.
• The patient has an unrealistic notion of what scar revision surgery will accomplish.
• The patient seems otherwise emotionally unstable.

In addition to discussing the timing and nature of treatments, the surgeon will take a careful medical history, noting whether the patient is a heavy smoker or has a family history of keloids, as well as other disorders that may influence the healing of scar tissue. These disorders include diabetes, lupus, scleroderma, and other disorders that compromise body's immune system.