Aesthetic characteristic of skin scars

The aesthetic characteristic of the scar is mainly subjective, since the scars of the same kind can absolutely suit one person and cause a depressive state in another. On the other hand, this concept is objective, since it can be evaluated using objective criteria. The latter refers primarily to the extent to which the scar is visible to others and to what extent it changes the perception of the contours of the face (body, limb). From this point of view, all scars can be conditionally divided into aesthetically acceptable and aesthetically unacceptable.

Aesthetically acceptable scars can be divided into hidden (imperceptible) and barely noticeable. Hidden scars are arranged in such a way that they are almost invisible, especially for an unprofessional look, and can be detected only by a detailed examination (within the scalp, in the natural folds of the skin, behind the cohosh of the auricle, on its back surface, etc.) ).

From hidden, scarred scars differ in minimal sizes (point and small normo- and atrophic scars) and their location (on hips and abdomen within the zone of "swimming trunks", on the foot, palmar surface of the hand and in other anatomical zones).

The concept of "barely noticeable" is largely conditional and can indicate not only that the scar is invisible to others, but that the patient himself pays little attention to him. Ultimately, it is the patient's position that determines to a greater extent whether or not to include a scar in the category of aesthetically acceptable.

Aesthetically unacceptable scars. Inclusion of the scar in the category of aesthetically unacceptable can be both objective and subjective.

So, objectively "unaesthetic" are scars of considerable length and width, hypertrophic and keloid types, located on open areas of the body and especially on the face. At the same time, even hidden scars may not suit patients with high demands.

That is why a detailed information about the nature of future scars plays an extremely important role in the work of a plastic surgeon.

In this regard, an important role is played by a pre-operative examination of the patient, who needs to inquire whether he had any operations or injuries in the past. The presence of normo- or atrophic scars in the patient indicates a normal reaction of his tissues to trauma. Hypertrophic and especially keloid scars can be a good reason to refuse cosmetic surgery.

If the patient was not operated during his life and there are no scars at all on his body, then it is necessary to predict their character in the future very carefully. In this case, the patient should be warned (including in writing) that the formation of hypertrophic and even keloid scars is theoretically possible, although in practice it is extremely rare. Direct, though not absolute, evidence of the normal response of tissues to trauma may be the absence of keloid scars in punctured ear lobes.

The next step in informing potential patients is a brief description of the scars usually formed after a particular operation.

[1], [2], [3], [4]