Scars can represent a slight blemish of various entity, until becoming a disfiguring mark. The scar is considered normal if it corresponds to the surface of the cutaneous damage, if it has a colour similar to the near skins, if it is elastic, if there aren’t adhesions to the lower plans and if it does not create retractions and distortions. All that is beyond this description represents a pathological scar. Often in fact are hypertrophic scars, very thick and of intense red colour. Then there are scars called keloids, which prolong themselves to the near tissues and create ever-growing masses of remarkable dimensions. Moreover distrophic scars are so thin to let see subcutaneous woven or to increase like a laddered stocking. Some zones of our body react in an anomalous way carring more frequently to pathological scars then other zones. The presternal region, the axillary region, the neck are risk zones, while in other zones of our body, such as the eyelids, scars will be invisible after few months. .

Pre-operative evaluation

The scar must be estimated from a surgical point of view at the moment in which it is totally stabilized. That is to say to say that the surgeon must be able to assert that the warehouse process of collagen and of the rearrangement of the structure that has repaired the defect are stopped. Only after that it is possible to operate without the risk of a new exuberant process.

Operation

Although the plastic surgery would never erase a scar completely, there is a great variety of surgeries to improve and make them less apparent. Many scars remain evident because the shadow created by the introflession of the margins makes them seem more manifest. In these cases it is possible to remove the scars and to suture again the margins with particular techniques (dermoplasty), this allows to make the scar less evident. In case of extended cicatricial areas are used cutaneous espanders: inflatable prosthesis of various dimensions that can be inserted in every district of the body expanding the cutaneous surface and obtaining enough tissue to cover the imperfection.
Some scars can be levigated in order to render them more similar to the surrounding tissues, thanks to dermoabrasion. This procedure consists in the employment of a rotating abrasive instrument which thin the intact skin, making the contours of the scar less visible. The surgical correction of the scars can be performed in local anaesthesia and without admission; replacement of cutaneous espanders requires admission for 1 or 2 days.