Can revision surgery always be completed?
Dr De Silva is able to achieve excellent results in revision surgery and will operate on cases where he feels he can achieve a success that is within the patient expectations, if he cannot achieve this he may advise against further surgery. Dr De Silva asks some patients to send information such as medical history and photographs of their face in advance of a consultation to ensure that we are able to help.
Scarring can generally be improved, however, often requires revision facelift surgery to remove the existing scars and replace with healthy skin. Improvement of scars can be dependent on there being some loose skin to achieve.
Can scars be improved?
Unsatisfactory scars are caused by a combination of factors including surgical technique, the position of scars, closure techniques (stitches vs staples) and genetics (1% of patients can have healing issues with scars secondary to their genetics). Scars can generally be improved by a number of measures:
Surgeon’s technique. Surgeon’s use different techniques to complete a facelift and neck lifting procedure. Meticulous care and attention to detail are required to hide the facelift incisions in natural creases and curves.
Location of the incision. The incision and scars can be hidden by placing the visible portion of the incision inside the ear canal or opening behind the little lump in front of your ear called the tragus.
Multiple-layered meticulous closure. Multiple layered skin closure ensures that there are deep stitches to support the soft tissues once the superficial skin stitches are removed; this is key to avoid unattractive widened scars.
Bevelled incision. In hair-bearing skin, the use of bevelled incisions in the hairline enables hair to grow through the scar after surgery, hiding the scar in hair-bearing skin.
Deep plane face lifting technique. Lifting the deep tissues beneath the skin (SMAS or Deep Muscle Tightening) before skin closure is essential to give a natural-looking result and avoiding tension on the skin.
Stitches. There are different methods that can be used to close the skin. Some surgeons use staples to save time; however, they can leave marks, unsatisfactory scars and are uncomfortable to remove. Dr De Silva avoids the use of staples in all patients as the best healing is from the use of fine sutures in non-hair bearing skin.
Regenerative medicine. Dr De Silva has pioneered developed the use of signature regenerative medicine techniques to enhance scar resolution.