At a glance
Scar revision is a surgical procedure that improves the appearance, texture, or function of a scar left by a previous injury, burn, or operation. A surgeon reshapes or removes the original scar tissue and closes the skin in a way that produces a less visible, flatter, or more flexible result.
Scars form because the body repairs wounded skin with collagen fibres that are denser and more disorganised than normal skin. Revision surgery cannot erase a scar completely, but it can change its size, direction, colour, or the way it feels, making it blend better with the surrounding skin.
Medical Condition
Scar revision is considered when a scar causes physical discomfort, limits movement, or creates significant distress about appearance. The decision depends on the scar type, location, and how long ago it formed.
- Hypertrophic scars: thick, raised scars that stay within the original wound boundary and may itch or feel tight.
- Keloid scars: overgrown scar tissue that spreads beyond the wound edges, often on the chest, shoulders, or earlobes.
- Contracture scars: scars that tighten the skin, restrict joint movement, or limit facial expressions, commonly seen after burns.
- Widened or stretched scars that have spread with time or due to skin tension.
- Depressed or pitted scars, including those left by acne or chickenpox, where the skin sits below the surrounding surface.
- Scars that distort nearby features such as the eyelid, lip, or nostril.
- Scars from previous surgery that healed in a prominent or misaligned position.
Revision is usually not recommended in certain situations. A scar that is less than one to two years old is still maturing, and surgeons typically prefer to wait until it has stabilised. Patients with active skin infections, uncontrolled diabetes, or bleeding disorders may need those conditions managed first. People who have formed keloids before carry a higher risk of the scar returning in the same way, and the surgeon will discuss whether surgery is the right approach.
Risks & Complications
Scar revision is generally safe, but like any surgical procedure it carries recognised risks that vary with the technique used, the scar location, and each patient's skin type.
- A new scar that is still noticeable, because no technique can guarantee invisible healing.
- Recurrence of the original scar type, especially with keloids, which have a tendency to grow back.
- Infection at the wound site, which may require antibiotics or further treatment.
- Poor wound healing or wound separation (dehiscence), particularly in areas with high skin tension.
- Changes in skin sensation, including numbness or increased sensitivity around the scar.
- Swelling and bruising in the treated area, which usually resolves over several weeks.
- Skin discolouration or pigmentation changes, more likely in darker skin tones.
- Allergic reaction to anaesthetic agents or suture materials.
- Asymmetry if the scar involves the face or a paired structure.
Preparation & Procedure
Before the procedure, the surgeon will assess the scar in person, review your medical and skin history, and decide which technique is appropriate. Photographs are usually taken for the medical record and for comparing results later.
In the weeks before surgery, most surgeons ask patients to stop smoking, because nicotine narrows the small blood vessels that keep healing skin alive. Alcohol is usually restricted in the days leading up to the procedure. Blood-thinning medications, including certain common pain relievers, are typically paused for about one to two weeks beforehand to reduce bleeding risk. Your surgical team will give you a specific list of which medicines to pause.
If general anaesthesia (where you are fully asleep) is planned, you will be asked to stop eating and drinking for several hours before the procedure, usually from midnight the night before. For procedures done under local anaesthesia (where only the skin area is numbed), fasting rules may be less strict, but your team will confirm.
Common pre-operative tests may include a blood count, clotting tests, and, for older patients or those with underlying conditions, an electrocardiogram (EKG, a heart tracing) or chest X-ray.
The procedure itself follows a general sequence, though the exact steps depend on the technique chosen.
- You are brought to the operating or treatment room and made comfortable on the table.
- Anaesthetic is given, either local injection to numb the area, sedation, or general anaesthesia, depending on how large or complex the revision is.
- The surgeon cleans and marks the area to be treated.
- The scar tissue is cut away, repositioned, or treated, depending on the technique. Common approaches include simple excision and re-closure, Z-plasty or W-plasty (methods that break up a straight scar line into smaller angled segments to reduce tightness and visibility), skin grafting (moving skin from another body area to cover the revised site), or tissue expansion (stretching nearby healthy skin to replace scar tissue).
- The wound is closed in layers using sutures (stitches), and sometimes surgical tape or skin glue is added on top.
- A dressing is applied to protect the site.
Aftercare
Recovery after scar revision varies considerably depending on the technique used and how large the treated area is. Simple revisions done under local anaesthetic are often performed as day procedures, while more extensive work involving skin grafts or tissue expansion usually requires at least one night in hospital.
- The wound site should be kept clean and dry according to the surgeon's specific instructions; the dressing is usually changed at the first follow-up visit.
- Sutures are removed at a time decided by the surgeon, often between five and fourteen days after the procedure, depending on location.
- Sun exposure to the healing scar should be avoided or covered with a high-protection sunscreen for several months, as new scar tissue is particularly sensitive to UV light and can darken permanently.
- Strenuous activity, heavy lifting, and anything that stretches the healing wound is restricted, usually for several weeks.
- Silicone gel sheets or silicone-based creams may be recommended to help flatten and soften the new scar; these are typically worn or applied for months.
- Steroid injections into the scar may be recommended at follow-up visits if the new scar starts to thicken.
- For contracture repairs near a joint, physiotherapy (guided exercise to restore movement) may be part of the recovery plan.
- Follow-up appointments are typically scheduled at regular intervals during the first year, as the final appearance of the scar takes many months to become clear.
- Patients should contact their surgical team promptly if they notice increasing redness, warmth, discharge from the wound, or fever, as these can signal infection.
Cost & What Determines It
The cost of scar revision varies widely because the procedure covers a spectrum of complexity, from removing a small facial scar under local anaesthetic to reconstructing a large burn contracture with a skin graft and physiotherapy. No two cases are priced the same, and comparing quotes meaningfully requires a detailed assessment of your specific scar.
- Size, depth, and location of the scar: larger or more complex scars require longer operating time and greater surgical skill.
- Technique chosen: simple excision costs considerably less than Z-plasty, skin grafting, or tissue expansion, which involve additional materials and often longer hospital stays.
- Type of anaesthesia: local anaesthesia is less expensive than sedation or general anaesthesia, which also requires an anaesthetist's fee.
- Hospital class and country: a procedure performed in a private tertiary hospital in a major medical tourism destination is priced differently from the same procedure in a community hospital.
- Length of stay: day procedures avoid bed and nursing costs; overnight or multi-day admissions add significantly to the total.
- Implants or materials used: silicone tissue expanders, biological skin substitutes, and specialised suture materials carry their own costs.
- Additional treatments included in the plan: steroid injections, laser sessions, or silicone sheeting prescribed as part of the protocol will affect the overall price.
- Pre-operative tests and post-operative consultations: these are sometimes bundled and sometimes billed separately.
Many hospitals that serve international patients offer a package price that typically covers the surgeon's fee, anaesthetist's fee, operating room use, and the standard hospital stay. Items that are often billed outside the package include pathology if removed tissue is sent for analysis, specialised dressings, physiotherapy sessions, prescription medications to take home, and any unplanned return to theatre.
For Indonesian patients, BPJS Kesehatan does not cover medical procedures performed abroad, and most Indonesian health insurance policies also exclude overseas treatment. This means costs are almost always paid out of pocket or through a private international health insurance plan that explicitly covers planned surgery abroad. Before travelling, ask the hospital for a written, itemised cost estimate that covers both expected and commonly incurred additional charges. Having this document in hand is the most reliable way to plan your budget and avoid unexpected bills on arrival.
Frequently Asked Questions
How long does scar revision surgery take?
Most scar revision procedures take between 30 minutes and 2 hours, depending on the size, location, and type of scar being treated. A small facial scar may be finished in under an hour, while a large or complex scar on the body can take longer. Your surgeon will give you a clearer estimate after examining the scar in person.
How much does scar revision cost?
The cost varies based on several factors specific to this procedure, including the size and depth of the scar, the technique used (such as surgical excision, skin grafting, or flap repair), the number of areas treated, and the class of hospital or clinic you choose. A written estimate from the hospital, prepared after a consultation, is the most reliable way to get an accurate figure for your situation.
What kind of anaesthesia is used, and will it be painful?
Small scars are usually treated under local anaesthesia, meaning only the skin around the scar is numbed and you stay awake, while larger or more complex revisions may be done under general anaesthesia, where you are fully asleep. During the procedure itself you should not feel pain, though some pressure or pulling sensation is normal under local anaesthesia. After the anaesthesia wears off, mild to moderate soreness is common, and doctors typically prescribe pain relief to keep you comfortable in the first few days.
What warning signs should I watch for after scar revision surgery?
Contact your doctor promptly if you notice increasing redness, warmth, swelling, or discharge from the wound, as these can be signs of infection. A fever, worsening pain after the first few days, or a wound that starts to open should also be reported without delay. Some redness and mild swelling right after surgery is normal, but any symptom that is getting worse rather than better deserves attention.
This page is general information, not a substitute for medical advice. Every case is different. Your doctor decides what is right for you.
