Scar Revision in the 21st Century

Whenever a skin incision is made in an adult, a scar will result. In fact, the only tissue in the human body that does not scar is bone. The question is, to what degree will a scar form? Facial scarring can publicly distort a patient's persona and be mentally devastating to the patient. In addition, facial scarring can decrease the quality of life by compromising the five senses (sight, hearing, smell, taste, and touch).

Any process that delays wound healing or induces chronic inflammation increases the risk of further scarring. Thus, methods to decrease tissue inflammation or improve wound healing will result in less scarring. In addition, with the knowledge that scarring does not occur in the first trimester in fetal development, it may be possible to alter the phenotypical expression of scarring. With the advent of cytokines to adjust wound healing, it also may be possible to modify scar formation before it occurs. Possibilities such as these could lead to future scar treatment.

In this issue, “Scar Revision in the 21st Century,” current and new methods to reduce or treat scarring are presented. The topics described are practical ways to prevent scarring and predict scarring after healing by secondary intention, along with scar revision techniques, managing keloids, innovative scar treatment modalities with botulinum toxin and topical therapies, and methods to camouflage scarring.

This issue attempts to describe some of the interesting and practical topics to manage scars in the current state and in the future. It does not intend to include all of the methods for scar revision, but instead to highlight its relevant topics. As a guest editor, it has been a pleasure to share with you this issue on scars in Facial Plastic Surgery. We would like to thank the authors for their significant contributions and hope the readers will find it informative.