Q: Dr. Eppley, it is hard to find a good scar revision specialist who can answer some basic questions without a formal consultation. As you have already answered my initial questions in regards to my scar, I would like to ask you my most important last question that is still on my mind.I still have not decided what to do about my scar. The best treatment would be excision as most of the doctors have recommended. But the reason why i still have not gone for excision is that I do not like the fact that my scar will be much longer. My chin scar is 0.3 cm wide and 0.5 cm long now. I had a prior consultation with scar revision specialist and he said that scar will be about 1.2 cm long after the revision which I do not like. He would place it in a curved or oblique line that parallels the curve of my chin pad – this is called a resting skin tension line (RSTL). I saw many scars after excision so why some of them are not so long even though they are as wide as mine. I would appreciate your answer.
A: The best treatment for your scar is a two-stage excision scar revision approach that does not make the scar any longer. The problem with your scar is that it is wide over a tight chin area. While it can be removed as a single stage procedure, the scar length would nearly double in size. Because of its width it is best served by doing a subtotal excision, let it heal for three months, and then doing a second stage completion scar revision. This is the only way to improve your scar without making it any longer.
Dr. Barry Eppley