Surgical and non-surgical improvement of hypertrophic scars, keloids, contractures and unsightly surgical scars — restoring appearance and function by Dr. Pranav Thusay.
All wounds heal with scars — but not all scars are equal. Hypertrophic scars are raised, red and firm. Keloids grow beyond the original wound margin. Contractures restrict movement when scars cross joints. Unsightly surgical or traumatic scars cause persistent self-consciousness. Scar revision improves the appearance, texture and functional impact of problematic scars through a combination of surgical, injectable and laser techniques.
Type, age, location and functional impact of the scar assessed. Photography. Discussion of realistic improvement — scar revision improves, not erases, a scar.
Steroid injections, silicone sheets and massage for early hypertrophic scars and keloids before considering surgery.
Planned excision and closure — Z-plasty, W-plasty or straight excision with layered closure. Contracture release with flap or skin graft for functional scars.
Silicone gel or sheeting applied from 2 weeks post-surgery. Sunscreen to protect the scar during maturation. Steroid injections at 6 weeks if thickening.
Scar maturation takes up to 18 months. The final result is judged at this point.
No — all surgical procedures create scars. Scar revision replaces a problematic scar with a finer, better-placed or less visible one. Realistic expectation-setting is the first step in any scar revision consultation.
A hypertrophic scar is raised and red but remains within the original wound boundaries and may improve over time. A keloid grows beyond the wound margins and rarely improves without treatment. Keloids are more common in darker skin types and on the chest, shoulders and ears.
Keloids are challenging to treat and have a significant recurrence risk after excision alone. The best outcomes are achieved with combined surgery + immediate post-operative steroid injections + radiation therapy (in some centres). Dr. Thusay will discuss the realistic outcomes and recurrence risk for your specific keloid.
Scars must be allowed to fully mature (typically 12–18 months) before surgical revision — unless there is a functional contracture requiring earlier release. Non-surgical treatments can be started much earlier to influence how the scar matures.
Yes — fractional laser (such as CO2 or Erbium) can significantly improve the texture, colour and surface of hypertrophic scars and acne scars. Pulsed dye laser is particularly effective for redness. Dr. Thusay will recommend the appropriate modality based on your scar type.
A contracture is a scar that has shortened and tightened, restricting movement at a joint. Contractures across the neck, axilla (armpit), elbow or fingers can significantly impair function. Unlike cosmetic scar revision, contracture release should not be delayed if function is compromised.
In most cases, yes — significantly so. A well-planned scar revision by an experienced plastic surgeon produces a finer, better-orientated scar in a more concealed location, with improved colour and texture over 12–18 months of maturation.
Silicone gel or silicone sheets are the most evidence-based non-surgical treatment for hypertrophic scars — they soften, flatten and reduce redness when used consistently for 3–6 months. They are most effective on scars less than 2 years old.
Dr. Pranav Thusay will personally assess your case and create a tailored plan.