More Effective Facial Scar Revision in Asian

Choi, Hyun Gon; Lee, Soo Hyang; Kim, Sun Hum; Shin, Dong Hyeok; Uhm, Ki Il; Kim, Heon Jun; Choi, Jae Koo

Abstract

Facial scar is very stressful for patients and physicians, especially in the case of non-parallel to relaxed skin tension line (RSTL). In general, for long facial scar not parallel to RSTL, Z-plasty or W-plasty has been performed to change the direction of scar or divide it into multiple segmented scar. These methods would be suboptimal, however, in the instance of Asian skin prone to scar formation. So, we experienced good results for scar revision through scar excision and solid subcutaneous- dermal repair to minimize scar widening despite of leaving linear type of scar. From July 2004 to March 2007, our methods were undergone for facial scar longer than 3cm in 84 patients. All scars were excised along the scar margin and subcutaneous tissue and dermis were repaired using single layer of subcutaneous-dermal stitch with 4-0 or 5-0 PDS to elevate wound margin 3-4mm higher than adjacent skin surface. Skin was repaired with 6-0 Prolene. The rate of satisfaction was over 89%(75 of 84 patients), the mean scar widening was 0.61+/-0.20 mm, and secondary operations were made in 3 patients. The Asian skin has some characteristics such as thick skin, increased melanin, energetic proliferation of fibroblast, and vigorous collagen formation, etc. Because of characteristics of Asian skin mentioned above, the linear pattern repair, technically easier than Z-plasty or W-plasty, would be superior to them in terms of the results. The essentially important point for scar revision in linear pattern is very strong subcutaneous-dermal repair to make elevation of wound margin enough for tolerating the skin tension and preventing scar widening.