A Combination Approach to Surgical Scars

BACKGROUNDScar formation from surgical procedures is an unavoidable risk. Despite measures taken by both the surgeon and patient during the perioperative and postoperative periods to maximize cosmesis, some patients will wish to pursue surgical or laser scar revision. OBJECTIVEThe authors propose a treatment algorithm to assist in approaching surgical scar revision with combination treatments. MATERIALS AND METHODSA PubMed search was performed on various surgical scar revision techniques. The authors augment these findings with their own personal experiences. RESULTSReports of surgical excision, intralesional corticosteroid injection, intralesional 5-fluorouracil injection, pulse dye laser treatment, nonablative fractional laser resurfacing, ablative fractional laser resurfacing, and microneedling and fractional needle radiofrequency, used in isolation or combination, were found. The authors also provide clinical photographs documenting improvement in appearance of surgical scars using these treatments. CONCLUSIONSurgical scars are best treated with a combination approach to address various features of the scar. The authors propose a treatment algorithm with multiple treatment options and how to combine them safely and effectively.