Scar revision pre-operative information
All cosmetic surgery involves risks and individual results vary. Cosmetic surgery is a serious decision. Decisions about whether to proceed should be made after careful consideration and following at least two consultations with a qualified medical practitioner.
This page provides pre-operative and post-operative information for patients preparing for scar revision. The specific technique recommended for your scar will have been discussed at your consultations — the information below covers the range of approaches and what to expect from surgical revision in particular.
About Scar Revision
Scars form as part of the body’s normal healing response after injury, surgery, or skin disease such as acne. All scars are permanent — scar revision does not erase a scar but improves its appearance, texture, position, or width so that it is less conspicuous and more consistent with the surrounding skin. Some scars respond well to non-surgical treatments; others are better addressed with surgery. The approach best suited to your scar will have been discussed at your consultation.
Non-surgical approaches
- Topical treatments — silicone gel or silicone sheeting is the most evidence-based topical option for raised (hypertrophic) scars; it flattens, softens, and lightens the scar with consistent use over three to six months
- Steroid injections — intralesional triamcinolone acetonide injections are effective for firm, raised, or hypertrophic scars; a series of injections administered over four to six weeks progressively softens and flattens the scar
- Collagen injections — useful for depressed (atrophic) scars to improve surface contour; effects are temporary
- Laser resurfacing — removes the surface layers of the scar to allow smoother re-epithelialisation and improved texture and pigmentation
- Dermabrasion — mechanical abrasion of the scar surface to blend it with surrounding skin
Surgical scar revision
Where non-surgical approaches are insufficient, surgical excision of the scar and re-closure under minimal tension — using advanced flap techniques, W-plasty, Z-plasty, or geometric broken line closure depending on the location and orientation — can significantly improve appearance. For large areas, a skin graft may be required. Surgery is typically performed under local anaesthesia, with sedation or general anaesthesia reserved for larger or more complex revisions.
An important principle: scars following cosmetic surgery generally require a waiting period of at least twelve months before revision is appropriate, as the majority of scar maturation occurs during this time and many scars improve substantially without intervention. For post-traumatic scars or other specific presentations, the timing of revision is individualised and discussed at consultation.
Before Surgery
Medications to Cease
- Aspirin and aspirin-containing products
- Ibuprofen (Nurofen, Advil) and all anti-inflammatory medications
- Naproxen (Naprosyn, Naprogesic)
- Warfarin, clopidogrel, or other anticoagulants — discuss with Dr Roth and your GP before stopping
- Vitamin E supplements, fish oil, garlic tablets, ginkgo biloba, ginseng, St John’s Wort
A full list is available on the Medications to Avoid page →
Smoking
Smoking significantly impairs wound healing and increases the risk of the revised scar healing poorly. Cessation for at least two to four weeks before and after surgery is strongly recommended. Smokers have a substantially higher rate of scar recurrence and poor wound outcomes.
Skin Condition
Surgery should not be undertaken if there is active acne, infection, or skin inflammation in the area to be treated. Please advise Dr Roth of any changes to the skin in the planned treatment area before your surgery date.
Fasting (surgical revision under general or sedation anaesthesia)
- No solid food or milk for at least six hours before surgery
- Clear fluids permitted up to two hours before — confirmed by the hospital the day before
- For procedures performed under local anaesthesia in the rooms, fasting is not required
What to Expect in Recovery
Important Post-Operative Instructions
- Begin silicone gel or silicone sheeting as soon as the wound has healed and sutures are removed — use consistently, twice daily, for at least three months
- Apply SPF 50+ sunscreen to the scar whenever it is exposed to sun — UV exposure causes permanent pigmentation change in healing scars
- Do not scratch or pick at the scar during healing
- Avoid activities that put tension on the wound for at least two to four weeks, depending on the location
- Do not smoke during the healing period
- Report any signs of infection (increasing redness, warmth, swelling, or discharge) to the rooms promptly
When to Seek Urgent Assistance
- Sudden, rapidly increasing swelling — may indicate a haematoma requiring urgent drainage
- Fever above 38.5°C
- Increasing pain not controlled by prescribed medication
- Increasing redness, warmth, or purulent discharge
Dr Roth’s rooms: (02) 9982 3439 | Out of hours: attend the nearest emergency department.
Specialist Otolaryngologist & Head and Neck Surgeon
Specialist registration — Otorhinolaryngology, Head & Neck Surgery
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