Hypertrophic scars are often confused with keloids, since both tend to be thick, red, and raised. However hypertrophic scars remain within the boundaries of the original incision or wound. They often improve on their own – though it may take a year or more – or with the help of steroid applications or injections.
The hypertrophic scar in the diagram has formed a contracture, restricting finger motion.
Hypertrophic scars can often be improved surgically if needed. Dr. Lesavoy 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 Dr. Lesavoy decide. You may receive steroid injections during surgery and at intervals for up to two years afterward to prevent the thick scar from reforming.
Dr. Lesavoy will use Z-plasty to remove the scar and several incisions will be made on each side, creating small triangular flaps of skin. Then the flaps are rearranged and interlocked to cover the affected area.
The incision will then be closed with a Z-shaped line of sutures. The new scar is thinner and less visable, and also allows the finger to be extended.