Scar Revision in Delafield
A scar that fades into the background.
Scar revision improves the appearance, texture, and function of an existing scar. Medicine approaches it several ways, from surgical excision and tissue rearrangement through to resurfacing and injectable treatments. At Consona the work is surgical: the scar is excised and the wound edges realigned along the skin's natural tension lines, by the plastic surgeon who, in the case of a scar from an operation done here, placed the original incision.
At a Glance
- Scar revision techniques include surgical excision, Z-plasty, W-plasty, laser resurfacing, and injectable treatments[1]
- Treatment timing depends on scar type, with some scars treatable as early as 1-2 months and others benefiting from additional maturation[2]
- Z-plasty and W-plasty reorient scar lines along natural skin tension lines to improve appearance and flexibility[4]
- Scar revision improves appearance but does not completely eliminate the scar[3]
Overview
Scars are a normal outcome of wound healing, but their size, shape, color, or texture can cause cosmetic concern or physical discomfort. Scar revision includes surgical and dermatologic techniques intended to make a scar less conspicuous and better integrated with the surrounding skin. No procedure erases a scar. Revision replaces the existing scar with one that is thinner, better placed, or oriented along a line the skin already has.
The appropriate technique depends on whether the scar is atrophic, hypertrophic, keloid, or a contracture, as well as its location, the patient’s skin, and how long the scar has been present. Z-plasty and W-plasty can reorient a scar along natural skin tension lines, helping it settle flatter and appear less visible. Non-surgical treatments, including laser therapy and silicone-based treatment, address the scar’s surface rather than its orientation.
Timing varies by scar. Many scars can be addressed one to two months after the original injury. Hypertrophic and keloid scars often respond better to earlier intervention than people expect, so an early consultation costs nothing and occasionally changes the plan.
Dr. Boehm performs surgical excision and reorientation, including Z-plasty and W-plasty. Laser resurfacing is not offered here. A flat scar whose main problem is redness or discoloration rather than shape is better suited to laser treatment elsewhere, and a referral is made rather than substituting an operation. The first question is whether the scar has a width problem, an orientation problem, or a color problem. Surgery addresses the first two, not the third, so the assessment begins with the scar itself rather than what caused it.
What to expect
- Initial consultation includes a thorough examination of the scar, discussion of treatment goals, and review of the patient's medical history, medications, and prior scar treatments.
- Scar maturity, type (atrophic, hypertrophic, keloid, or contracture), and surrounding skin quality are evaluated to determine the most appropriate revision technique.
- Where the assessment points to resurfacing rather than surgery, that is said at this visit and a referral is made. Nothing further below applies to a scar better served somewhere else.
- Pre-procedure photographs are taken for documentation, and the treatment plan is discussed with the patient including expected outcomes and limitations.
- The treatment area is cleaned with antiseptic solution, and the planned incision pattern (Z-plasty, W-plasty, or fusiform excision) is marked on the skin.
- Local anesthesia is administered to numb the scar and the surrounding tissue.
- The scar tissue is excised. For a wide or tethered scar the surrounding tissue is undermined first, so the edges can be brought together without the tension that widened the original scar.
- Closure is layered, with deep sutures taking the tension off the skin edge and fine sutures approximating the surface. Tension at the skin is what produces a wide scar, so where it is carried is most of what determines the result.
- A sterile dressing is applied, and detailed wound care instructions are provided including activity restrictions and follow-up scheduling.
- Suture removal is performed at the appropriate interval (typically 6-14 days depending on location), and ongoing scar management including silicone therapy and sun protection is initiated.
How a scar revision works
- Surgical excision removes the existing scar tissue entirely. The wound edges are then realigned along natural skin tension lines and closed with precise suturing to produce a thinner, less visible scar. This is the form of scar revision Dr. Boehm performs.
- When a scar crosses a natural tension line instead of following it, Z-plasty or W-plasty changes the direction of the scar line. This does not make the scar shorter and often makes it longer. A longer scar that follows a natural line can appear far less visible than a shorter scar that cuts across one.
- Resurfacing works on the surface of a scar rather than its orientation. Microneedling uses controlled micro-injury to remodel collagen and improve texture and pliability, while laser treatment reduces redness. Neither treatment is offered here. If resurfacing is the appropriate approach, it is identified and a referral is made rather than replacing it with surgery.
- Injectable corticosteroid reduces inflammation and flattens hypertrophic and keloid scars by inhibiting collagen synthesis. Whether it is the appropriate first step for a particular scar, and whether treatment takes place here or elsewhere, is determined at the consultation.
- Dr. Boehm assesses scars from abdominoplasty, arm lift, breast surgery, and post-weight-loss contouring performed here. In those cases, he planned the original incision and knows how it was closed and where tension was carried.
When it's recommended
- Hypertrophic or raised scars that are cosmetically unacceptable
- Wide or stretched scars from surgical incisions or trauma
- Scars in cosmetically prominent areas such as the face or neck
- Depressed or atrophic scars that create visible skin irregularities
- Scars with abnormal pigmentation (red, hyperpigmented, or hypopigmented)
- Keloid scars that extend beyond the original wound boundaries
Is a scar revision right for you?
Reach out to learn more from Dr. Lucas Boehm.
Recovery & aftercare
- Initial healing occurs within 1-3 weeks depending on the technique and location
- Sutures are typically removed within 6-14 days for surgical techniques
- Activity restrictions including avoidance of heavy lifting and strenuous exercise for 2-6 weeks
- The revision site may remain pink or red for several months during healing
- Final scar appearance develops over 6-18 months as the tissue continues to remodel
- Consistent sun protection is essential during healing to prevent discoloration
- Silicone sheets or gel and scar massage may be recommended to optimize the final result
Alternatives
- Laser resurfacing as a standalone treatment for mild to moderate scars
- Corticosteroid injections for hypertrophic or keloid scars
- Silicone-based topical treatments for scar prevention and improvement
- Microneedling to stimulate collagen remodeling in superficial scars
- Microdermabrasion for surface-level scar texture improvement
Frequently Asked Questions
- Treatment timing varies. Dr. Boehm typically evaluates a scar for the first time about one to two months after the original injury or surgery, and earlier treatment results in better long-term cosmetic outcomes. Hypertrophic and keloid scars often benefit from earlier intervention than people expect.
- No. Scar revision significantly improves a scar’s appearance but does not eliminate it. The aim is to improve its color, texture, orientation, or contour so it blends more naturally with the surrounding skin. Realistic expectations need to be established before treatment begins.
- Wide or stretched surgical scars, raised and firm hypertrophic scars, and scars that run against natural skin tension lines tend to respond well. Keloid scars can also be treated, but they have a higher recurrence rate and often require combination treatment that includes steroid injections.
- Initial healing takes a few weeks, but the revised scar continues to change over 6 to 18 months. During that time, it gradually becomes flatter, softer, and less noticeable. Following the aftercare instructions provided, including silicone therapy and sun protection, helps optimize the outcome.
- No. Dr. Boehm performs surgical scar revision, not laser resurfacing. For a flat scar whose main problem is redness or discoloration rather than shape, laser treatment may be the appropriate tool and is available elsewhere. No technique erases a scar; revision replaces it with one that is thinner, better placed, or oriented along a natural skin line.
- Yes. The assessment begins with the type of scar rather than its cause. Atrophic, hypertrophic, keloid, and contracture scars behave differently and respond to different treatments, as does a scar that crosses a natural skin tension line instead of following it. Timing also matters: many scars can be addressed one to two months after the original injury, and hypertrophic and keloid scars often respond better to earlier intervention than people expect.
- Scar Revision may not be appropriate for individuals with active infection at or near the scar site or unrealistic expectations about achieving scar-free skin. Possible side effects include recurrence of hypertrophic or keloid scarring, particularly in predisposed individuals, infection at the surgical site, bleeding or hematoma formation. Dr. Boehm will review your health history to ensure Scar Revision is safe for you.
- Scar Revision is commonly recommended for individuals experiencing hypertrophic or raised scars that are cosmetically unacceptable, wide or stretched scars from surgical incisions or trauma, scars in cosmetically prominent areas such as the face or neck, depressed or atrophic scars that create visible skin irregularities. Schedule a consultation with Dr. Boehm in Delafield to find out if Scar Revision is right for you.
Scar Revision risks & candidacy
Who should avoid this
- Active infection at or near the scar site
- Unrealistic expectations about achieving scar-free skin
- Active inflammatory skin conditions at the treatment site
- Certain connective tissue disorders that impair wound healing
- Recent or current isotretinoin treatment for surgical procedures
Possible risks
- Recurrence of hypertrophic or keloid scarring, particularly in predisposed individuals
- Infection at the surgical site
- Bleeding or hematoma formation
- Wound dehiscence (separation of wound edges)
- Hyperpigmentation or hypopigmentation at the revision site
- Nerve damage causing temporary or permanent numbness
- Unsatisfactory cosmetic outcome requiring additional procedures
Your surgeon
Care that respects what makes you, you.
Dr. Lucas Boehm is a Wisconsin native, board-certified, fellowship-trained plastic surgeon and the founder of Consona Plastic Surgery and Aesthetics. His practice is dedicated exclusively to aesthetic surgery of the face, nose, breast, and body, with particular expertise in deep plane facelifts, rhinoplasty, and aesthetic breast surgery. He completed his undergraduate education at the University of Wisconsin–Madison, earned his medical degree from the Medical College of Wisconsin, and completed his plastic surgery residency there as well. He then pursued an Aesthetic Society-endorsed fellowship in aesthetic surgery under the mentorship of Dr. Bradley Calobrace in Louisville, Kentucky. Known for meticulous attention to detail, he approaches each case with precision and intention. His philosophy emphasizes harmony and balance – enhancing what is already beautiful while ensuring every change feels natural, thoughtful, and uniquely you.
- Board-certified
- Am. Board of Plastic Surgery
- Fellowship-trained
- Aesthetic surgery
- 12+ years
- In practice
Sources & references
This article draws on 5 sources, including peer-reviewed research, leading medical institutions.
Government & research
Medical institutions
Medically reviewed by Dr. Lucas Boehm, MD · Last reviewed: 2026-09-12