Is A Geometric Broken Line Closure Technique Best For My Scar Revision?
Q: Dr. Eppley, I am interested in a geometric broken line closure scar revision but I have a few questions.
1) Would you do multiple layer closure underneath the skin to ensure that there is proper wound undermining. If so many layers?
2) Since I’d be an out of town patient could you use dissolvable sutures on the outside?
3) Would dissolvable sutures affect the outcome negatively or it shouldn’t?
4) Is there anything you can do to help prevent the scar incision becoming indented and the outside edges looking raised?
5) Do you normally have to perform dermabrasion after the GBLR and if so when would this be performed? Would it cost more if I had to do dermabrasion later.
6) Given the size and location of my scar right in the middle of my cheek in your professional opinion do you think that GBLR is my best option? I just worry having different zig zaggy shapes might be more noticeable than a straight line but the problem I have with the straight line is how the edges are raised.
7) I had scar revision done 7 months ago do you think that it is ok to do another revision now since I know the raised edges won’t get better or do you think it’s too early?
A: In answer to your questions about an irregular or geometric broken line scar revision:
1) Every plastic surgery wound closure uses multiple layers.
4) That happens when there is scar widening. Interdigitating the scar limbs, like in a GBLC, helps prevent that.
5) Whether dermabrasion is needed later depends on how it heals. I would say the risk of that is way less than 50%. It is something that I find uncommon to need to do. Maybe a light laser resurfacing but not dermabrasion in your type of facial scar.
6) Your results with straight line closure have proven that approach is not adequate. It is either GBLC or leave it alone and accept its current appearance.
7) You do a revision when one is certain that no further improvements are going to happen with further healing.
Dr. Barry Eppley