When the skin is in the process of recovering from an injury such as a result of an accident, surgery, a burn or acne, scarring will occur wherever multiple layers of the skin have been affected.
Before deciding to have scar revision, the patient must be aware that scars can’t be removed completely. Once a scar forms, it is permanent but may be made less visible or relocated surgically.

Various types of scar

• Expanded scar
Scars can be expanded as time goes by. Unlike normal skin, scar tissue usually lacks elasticity and distribution of sweat gland. So once it expanded, it is difficult to be restored.

• Keloids
Keloids are thick, reddish and raised cluster of scar tissue that grows beyond the edges of the wound or incision. Keloids may form on any part of the body, although the upper chest, shoulders and upper back are especially prone to keloids formation. Symptoms include pigmentation of the skin, itchiness, redness, unusual sensations and pain.
Darkly pigmented people seem to be more prone to forming keloids.
keloids have a stubborn tendency to recur, sometimes even larger than before.

• Hypertrophic scar
A hypertrophic scar looks similar to a keloid, but does not extend beyond the original boundaries of the wound like keloids, and may fade with time. Hypertrophic scars are more common than keloids. Unlike Keloids, They occur in all racial groups.

• Depressed scar
Scar is usually reddish and elevated on the level of skin.
But sometimes we can see the depressed scar like a surface of moon.
This is made by laceration, inflammation or nail scratch wound in childhood.
Because the layer of dermis cannot be regenerated after complete injury, the depressed scar can be made after complete injury of the dermis.

• Multiple scar
Burns or other injuries resulting in the loss of a large area of skin may produce multiple scar(hypertrophic, erythma, contractures, etc.). These kinds of scar are difficult to treat with general methods such as medication or peeling.

Operative method for scars -Since  the  types  of  scar  vary, various types of treatment methods are used.

• Scar resection
Scar resection is effective when the scar is long and narrow. This is the most common and general method. In this procedure, scar is resected first and normal skin is sutured.
Although scar resection can make scars less obvious, it is impossible to make them disappear.

• Tissue expansion
Tissue expansion is the method of the stretching the skin near the area to be repaired with expander, and cover the affected area with expanded skin.
Tissue expansion offers several advantages- the match of skin is nearly perfect, the success rate is high because the skin retains its own blood and nerve supply, and scarring is reduced.

• Skin Grafting
Skin grafts and flaps are more serious than other forms of scar surgery.
Grafting involves the transfer of skin from a healthy part of the body to cover the injured area.
Flap surgery is more complex procedure in which skin, along with the underlying fat, blood vessels, and sometimes the muscle, is moved from a healthy part of the body to the injured site.
The treated area may take several weeks or months to heal, and a support garment or bandage may be necessary during recovery period.
Skin grafting and flap surgery can greatly improve the function of a scarred area.

• Peeling
Peeling is the method of removing the superficial layer of the skin. This can be applicable to wide and uneven scars, pockmarks and acne scars.
After treatment, patients should apply sunscreen on treated area to block out ultraviolet rays.