THE PROCEDURE

WHAT is Scar Revision?

Scars and wound healing are unpredictable. The way a scar develops depends on many factors including how your body heals, the type of the original injury, and on the surgeon's skills who initially treated the wound.

Many variables can affect the severity of scarring, including the size and depth of the wound, the blood supply to the area, the thickness and color of your skin, and the direction of the scar. Whether the appearance of a scar bothers you is a highly personal matter.

While no scar can be removed completely, a skilled Facial Plastic Surgeon can often improve the appearance of a scar, making it less obvious.

When Should Your Scar Be Treated?

Many scars that appear large and unattractive at first may become less noticeable with time. Some can be treated with steroid injections to relieve symptoms such as tenderness and itching. For these reasons, it is recommended to wait as long as a year after an injury or surgery before you decide to have scar revision.

Facial Scars

There are several ways to make a facial scar less noticeable. Often it is simply cut out and closed with tiny stitches, leaving a thinner, less noticeable scar.

If the scar lies across the natural skin creases Dr. Zimm may be able to make it appear less conspicuous by repositioning it to run parallel to these lines with a variety of surgical techniques.

Some facial scars can be softened using laser skin resurfacing which can level an elevated scar, but it won't completely erase the scar.

Enlarged Scars or Hypertrophic Scars

Hypertrophic scars are often confused with keloid scars since both tend to be thick, red, and raised. Hypertrophic scars, however, remain within the boundaries of the original incision or wound. They often improve on their own, though it may take a year or more. Hypertrophic scars may improve with the help of steroid applications or injections.

If a conservative approach doesn't appear to be effective, hypertrophic scars can often be improved surgically. The plastic surgeon will remove excess scar tissue, and may reposition the incision so that it heals in a less visible pattern. This surgery may be done under local or general anesthesia, depending on the scar's location and what you and your surgeon decide. You may receive steroid injections during surgery and at intervals for up to two years afterward to prevent the thick scar from reforming.

Contractures

Burns or other injuries resulting in the loss of a large area of skin may form a scar that pulls the edges of the skin together, a process called contraction. The resulting contracture may affect the adjacent muscles and tendons, restricting normal movement.

Correcting a contracture usually involves cutting out the scar and replacing it with a skin graft or a flap. In some cases a procedure known as Z-plasty may be used. New techniques, such as tissue expansion, are playing an increasingly important role. If the contracture has existed for some time, you may need physical therapy after surgery to restore full function.

After Scar Revision

As you heal, remember that no scar can be removed completely; the degree of improvement depends on the size and direction of your scar, the nature and quality of your skin, and how well you care for the wound after the operation. It is quite normal for your scar to look worse initially. It's important to remember that the final results of your surgery may not be apparent for some time.

Scar Revision Treatments or Surgery

Depending on the scar, Dr. Zimm may initially suggest less invasive treatments to minimize the appearance of your scar. These minimally invasive treatments can include laser resurfacing, pressure treatments, steroid, 5FU, or botox injections. If after your examination, he determines that your scar will require scar revision surgery, he will discuss this in depth with you. For many scars, scar revision can be preformed in the office with local anesthesia alone; however, depending on their location and size, some scars will require scar revision surgery at the hospital as an outpatient procedure.

Many patients combine scar revision with another cosmetic procedure they wish to have.

Keloid Scars

Keloids represent scar tissue that grow beyond the edges of the wound or incision. They are often red or darker in color than the surrounding skin. Keloids occur when the body continues to produce the tough, fibrous protein known as collagen after a wound has healed.

Keloids can appear anywhere on the body, but they're most common over the breastbone, on the earlobes, and on the shoulders. They occur more often in dark skinned people than in those who are fair. The tendency to develop keloid scars lessens with age.

Keloid scars are often treated by injecting a steroid medication directly into the scar tissue to reduce redness, itching, and burning. In some cases, this will also shrink the scar.

If steroid treatment is inadequate, the scar tissue can be removed and the wound closed with one or more layers of stitches. This is generally an outpatient procedure, performed under local anesthesia. You should be back at work in a day, and the stitches will be removed in a few days.

No matter what approach is taken, keloid scars have a stubborn tendency to recur, sometimes even larger than before. To discourage this, Dr. Zimm will combine scar removal with steroid injections, direct application of steroids during surgery and pressure therapy over the scar. Even so, a keloid scar may return, requiring a repeat procedures in a few years.

Z-Plasty

Z-plasty is a surgical technique that can be used to reposition a scar so that it more closely conforms to the natural lines and creases of the skin, where it will be less noticeable. It can also relieve the tension caused by scar contracture. However, not all scars can be repaired with a Z-plasty. While Z-plasty can make some scars less obvious, it won't make them disappear completely. A portion of the scar will still remain outside the lines of relaxation.

In the Z-plasty procedure, the old scar is removed and new incisions are made on each side, creating small triangular flaps of skin. These flaps are then rearranged to cover the wound at a different angle, giving the scar a "Z"pattern. The wound is closed with fine stitches, which are removed a few days later.

REVIEWS

FEATURED testimonials

"I am very happy with the results."

“Prior to the consultation, I was very uneasy about getting fillers in my cheeks because I didn’t want to look unnatural or feminine. Dr. Zimm senses my concerns and was very patient…before leaving his office, I knew exactly what to expect over the next few days after the injection. All in all, I am very happy with the results and I’m glad I found Dr. Zimm’s office.”

"My breathing is significantly improved and the cosmetic portion was beautifully done."

“…As a healthcare provider myself, I have worked with many physicians over the years and I can attest to his competence and professionalism. His practice is extremely well run and his excellent bedside manner, astute medical knowledge and involvement in the latest research put me at ease and allowed for me to completely trust his abilities… His passion for his field of work is evident, and I am extremely satisfied with the outcome of my sinus reconstruction and rhinoplasty -- my breathing is significantly improved and the cosmetic portion is beautifully done.”

"World-class Surgeon with a Small-town Manner"

“I was really impressed by how much he knew about state-of-the art surgical techniques and practiced them. He is clearly an extremely skilled surgeon. He is also a very intelligent and kind person. As someone who doesn't love the idea of surgery, I felt comfortable and confident… As someone who works as a professor and an artist, I can say that Dr. Zimm sets a high bar for engaging with people and teaching them about their condition, for putting people at ease and building trust, and for clearly being passionate about both the artistry and the technical dexterity of his work. I couldn't recommend him more.”

"He won me by his demeanor, his experience, strive for perfection and honesty."

“Need a perfect, natural-looking nose? Go nowhere else but to Dr. Zimm!...Being involved in the industry myself, I went to 13 different rhinoplasty consultations in NYC to find the right surgeon. After hearing lots of opinions, prices and seeing different images of the "perfect" nose, I chose Dr. Zimm. He won me by his demeanor, his experience, strive for perfection and honesty. He also didn't have a "signature" nose he puts on every one of his patients (walk around the UES and you'll know what I'm talking about). He is truly an amazing surgeon and anyone who works with him at the hospital will tell you the same.”

"Dr. Zimm made me feel as though he was treating a friend or family member."

“Working in the industry I have had the opportunity to work with many surgeons and am always very particular when choosing a physician myself, family, friends and so forth. Dr. Zimm recently performed a Blepharoplasty on me in his office. I consulted with 10 surgeons before moving forward and scheduling this surgery. Without hesitation, I have to say I could not have made a better choice in surgeons!!!! Dr. Zimm was confident and competent, he also had a wonderful bedside manner and made me feel as though he was treating a friend or family member of his own. Fantastic! Not to mention the results are amazing!!!! Completely natural, but amazing Thank you Dr. Zimm!!!!!!”

"Warm and extremely professional"

I am not one to write reviews, but Dr. Zimm deserves one. I had numerous consultations with other top rhinoplasty surgeons across the country but as soon as I had my consultation with Dr. Zimm, I immediately felt he was the right surgeon for me. I am very thankful I chose him. Heather and his entire staff have been warm and extremely professional. He is a brilliant surgeon. I can’t say enough positive things about my experience and would recommend him to anyone looking for a kind, patient, artistic surgeon.

"If I was asked to describe Dr. Zimm in two words I would say: 'GREAT HEALER!'"

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FAQs

Frequently asked questions

The ideal age varies depending on the procedure. Some surgeries, like rhinoplasty, are often performed in late teens or early twenties, while others are more common among older adults seeking anti-aging treatments.

When performed by a board-certified plastic surgeon in a accredited facility, plastic surgery is generally safe. However, all surgical procedures carry inherent risks, and individual factors also play a role in safety.

Recovery time varies depending on the procedure and individual healing abilities. Some treatments may have minimal downtime, while others may require several weeks of recuperation.

Skilled surgeons strive to provide natural-looking outcomes. Open communication with your surgeon about your expectations and goals is crucial for achieving the results you desire.

Most surgeries result in some scarring, but plastic surgeons aim to minimize scarring through careful incision placement and suturing techniques. Scar management post-surgery can also help.

The cost varies by procedure and location. We do not accept insurance.

It's crucial to select a board-certified plastic surgeon with extensive experience in the specific procedure you're interested in. Reading reviews, checking credentials, and scheduling consultations can help with this decision.

Risks include infection, scarring, anesthesia complications, and dissatisfaction with results. An open discussion with your surgeon about potential risks and how they can be minimized is essential.

 

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