More serious forms of scar surgery are skin grafts and skin flaps. These are more likely to be performed in a hospital as inpatient procedures, under the use of general anesthesia. The treated area may take several weeks or months to heal, and a support garment or bandage may be necessary for up to a year.
The process of grafting involves the transfer of skin from a healthy part of the body (the donor site) to cover the injured area. The graft is said to “take” when new blood vessels and scar tissue form in the injured area. While most grafts from a person’s own skin are successful, there are times that the graft doesn’t take. In addition, all grafts leave some scarring at both the donor and recipient sites.
Skin flap surgery is a complex procedure in which skin, the underlying fat, blood vessels, and sometimes the muscle, is moved from a healthy part of the body to the injured site. In some flaps, the blood supply remains attached at one end to the donor site, while in other, blood vessels in the flap are reattached to vessels at the new site using microvascular surgery.
Skin grafting and flap surgery can greatly improve the function of a scarred area. The cosmetic results may be less satisfactory, since the transferred skin may not match the color and texture of the surrounding skin. Generally, flap surgery produces better cosmetic results than skin grafts.