Scar revision
Surgery or other treatments to improve the look, feel or function of a scar — though a scar can be improved, it can never be completely removed.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- Scar revision aims to improve a scar's appearance, feel or function — it cannot remove a scar completely.
- Most scars improve with time, so revision is usually best delayed until the scar has matured, often a year or more.
- Keloid scars are different: surgery alone often makes them come back, so they need combined treatment and realistic expectations.
- Whether on the NHS or privately, the right starting point is understanding the scar type and what is realistic for it.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your surgeon will give you advice for your situation.
Can make a scar flatter, paler, narrower or less noticeable
An immature scar that is still improving on its own — revision is usually better delayed until it has matured.
Keep the wound clean and protected, with some swelling and discomfort expected. Simple pain relief usually helps. Injections or laser may leave the area...
Honest, written expectations about what improvement is realistic.
Keep the wound clean and protected, with some swelling and discomfort expected. Simple pain relief usually helps...
Non-dissolvable stitches are usually removed around 5–14 days. The new scar will look red and firm — this is...
The new scar is at its most red and firm and may need protecting and treating (for example with silicone or...
The scar gradually softens, flattens and fades. The final result of a revision is only clear once the scar has...
What is scar revision?
Scar revision is a group of treatments that aim to make a scar less noticeable, more comfortable, or less restricting. It can mean surgery to re-cut and re-close a scar more neatly, or non-surgical treatments such as steroid injections, silicone, pressure, laser or resurfacing. Often a combination is used.
The key thing to understand is that no treatment can completely remove a scar. Revision swaps an old scar for a new, hopefully better one, or improves the appearance and symptoms of the existing scar. The aim is improvement, not perfection.
Scar revision works best when a scar has fully matured, which can take a year or more, because scars often improve a lot on their own with time. Some scars — particularly raised, lumpy ones — behave differently. Hypertrophic scars stay within the original wound and often settle, while keloid scars grow beyond it, can come back after treatment, and are notoriously difficult to manage.
Because results vary so much, a careful assessment of the scar type, its cause and your skin matters before deciding what, if anything, to do.
Types & techniques
There isn't one single operation. The right approach depends on you — which is something to discuss with your surgeon.
Hypertrophic vs keloid scars
| Hypertrophic | Keloid | |
|---|---|---|
| Spread | Stays within the wound | Grows beyond the wound |
| Over time | Often settles on its own | Can keep growing, rarely settles |
| Surgery alone | Can help | Often comes back |
| Approach | May improve with time/treatment | Needs combined treatment, realistic aims |
Telling these apart matters, because it changes what treatment is sensible and how likely it is to last.
Preparing for your surgery
- Make sure your scar has had time to mature — many scars improve a lot on their own, so waiting is often part of the plan.
- Discuss what type of scar you have (for example hypertrophic or keloid), as this strongly affects what is realistic.
- Tell your clinician if you have a history of keloids or poor scarring, and whether previous scars behaved badly.
- Mention blood-thinning medicines, diabetes, smoking and any condition affecting healing.
- Be clear about what bothers you most — appearance, itching or tightness — so the plan targets that.
- Ask whether one treatment or a combination is planned, and how many sessions may be needed.
- Arrange time off and a lift home if you are having sedation or a general anaesthetic.
What happens
What happens depends on the treatment. Surgical revision is often done under local anaesthetic: the old scar is cut out, and the wound is closed carefully, sometimes with the scar repositioned along natural lines or rearranged (for example with a z-plasty) to relieve tightness. Larger revisions may use sedation or a general anaesthetic.
Non-surgical treatments are usually quicker. Steroid injections are given directly into a raised scar, often in a short clinic appointment and repeated over months. Laser, silicone and pressure therapies are applied over a course of treatment.
For difficult scars, especially keloids, several approaches are often combined — for example surgery followed by injections or pressure — and the plan is tailored to the scar. Your clinician will explain the steps and the likely number of sessions.
Is this operation right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- An immature scar that is still improving on its own — revision is usually better delayed until it has matured.
- Keloid-prone skin, where surgery alone is likely to make the scar worse and should only be part of a combined plan.
- Unrealistic expectations of a scar being removed completely, rather than improved.
- Active skin problems, infection or unstable conditions affecting the area.
Delay surgery if…
- The scar is still red, firm and changing, suggesting it has not yet matured.
- There is active infection or inflammation in or around the scar.
- Blood-thinning medicines need adjusting before surgery and this has not been arranged.
- Diabetes, smoking or another healing problem is not yet under control.
- You are unsure about your expectations and need more time to decide.
Alternatives to discuss
- Doing nothing and letting the scar continue to mature and fade.
- Non-surgical options alone: silicone, pressure, massage, steroid injections or laser.
- Camouflage make-up for appearance, avoiding any procedure.
- Combined non-surgical treatment for keloids rather than surgery.
- A specialist scar or dermatology opinion before deciding.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Anaesthetic choices
The safest option depends on the operation, your health, the facility and your surgeon/anaesthetist. Ask what is planned and why.
Benefits
- Can make a scar flatter, paler, narrower or less noticeable
- Can ease symptoms such as itching, tightness or discomfort
- Can release a scar that restricts movement or pulls on a feature
- Can reposition a poorly placed scar into a more natural line
- Combined treatment can reduce the chance of a raised scar coming back
Risks & complications
- A new scar that still shows — improvement, not removal
- Redness, firmness and swelling of the new scar at first
- Itching or altered sensation around the scar
- Colour changes (lighter or darker), especially in darker skin
- The result being no better, or occasionally worse, than before
- Wound infection or delayed healing
- Skin thinning, dimpling or colour loss from steroid injections
- A raised scar returning after treatment
- A keloid growing back larger than before, sometimes despite combined treatment
- A widened or stretched scar needing further treatment
- Skin changes from radiotherapy, if used for difficult keloids
The single most important point is that scar revision improves a scar but cannot erase it, and there is always a risk the result is no better. Keloid-prone skin is a special concern: surgery alone often makes keloids worse, so it should only be done as part of a combined plan with realistic expectations. People with darker skin or a tendency to keloids should make sure this is discussed. Ask your clinician what improvement is realistic for your scar type.
Published figures to discuss
How well a scar responds varies enormously with its type, cause, position and the person's skin. Most scars improve over time anyway, which makes it hard to know how much benefit comes from treatment. Keloids are a particular problem: even with treatment, recurrence is common. The figures below are cautious and reflect this uncertainty rather than predicting an individual result.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Keloid recurrence after steroid injection | Up to about half regrow | British Association of Dermatologists patient information states up to 50% of keloids grow back after steroid injection. | British Association of Dermatologists — Keloids (patient information)bad.org.ukPublished figure |
| Keloid recurrence after surgery alone | High; surgery alone is often unsuccessful | Why surgery is usually combined with injections, pressure or radiotherapy; exact rates vary widely by study. | Guide sourcesClinical context |
| Hypertrophic scars | Better outlook than keloids; often respond and settle | They stay within the wound and may improve with time and treatment, with lower recurrence than keloids. | Management of keloid and hypertrophic scars (PMC)pmc.ncbi.nlm.nih.govSource-linked context |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
Recovery — what to expect, and when
Recovery depends on the treatment. After surgical revision you have a fresh wound that heals over a week or two, but the new scar then takes many months to settle. Non-surgical treatments usually have little downtime but are spread over a course.
- A red, firm new scar that looks worse before it improves
- Itching and altered sensation as the scar heals
- Tightness that eases as the scar softens
- Bruising or temporary soreness after injections or laser
- A long wait — often up to a year — before the final result is clear
Aftercare
- Follow your wound-care instructions and keep the area clean.
- Use simple pain relief such as paracetamol if needed.
- Protect the new scar from the sun, which can darken it, for at least a year.
- Use silicone gel or sheets and massage the scar if advised, to help it settle.
- Do not smoke, as it impairs healing and scar quality.
- Attend any planned injection, laser or pressure-therapy sessions.
- Be patient — judge the result only once the scar has matured.
- Report any sign of infection or a scar growing back.
- Wound-care instructions understood
- Silicone gel or sheets ready if advised
- Sun protection for the scar
- Dates booked for any follow-up injection or laser sessions
- Pain relief at home
- Realistic expectations discussed and noted
- Clinic contact number saved for problems
Scars and how they heal
Scar revision always leaves a scar — the aim is a better one, not none. After surgery the new scar starts red and firm and softens and fades over many months. Results depend heavily on the scar type, its position, and your skin's healing tendencies. Raised (hypertrophic) scars may improve; keloids can return or worsen. Sun protection, silicone and massage can help a scar settle, but some scars stay visible.
⚠ Get urgent help if…
- Increasing redness, heat, swelling or pus around the wound (infection)
- Spreading redness with fever or feeling unwell
- Bleeding that does not stop with gentle pressure
- Wound edges coming apart
- A scar growing rapidly, becoming itchier or extending beyond the wound (possible keloid)
- Skin thinning, denting or marked colour loss after injections
- Worsening rather than improving pain
Who to contact: your surgeon or clinic first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your surgeon gives you.
Results & realistic expectations
A good result means the scar is flatter, paler, narrower, more comfortable or less restrictive, and sits in a more natural line. But results vary widely and take many months to a year to settle, and a scar can never be completely removed. Sometimes the result is only modestly better, and occasionally it is no better at all.
For keloids in particular, even combined treatment may not prevent recurrence, and it is reasonable to weigh up whether treatment is worthwhile. Honest expectation-setting before treatment is the most useful thing a clinician can offer.
Once a revised scar has matured, the improvement is usually long-lasting, though it keeps fading slowly for a while. Hypertrophic scars that settle tend to stay settled. Keloids are different: they can recur months or years later, which is why ongoing treatments (such as silicone, pressure or repeat injections) are often part of the plan. Sun protection helps any scar stay less noticeable long-term.
Combining with other procedures
Scar treatments are often combined for the best chance of improvement — for example surgical revision followed by steroid injections, silicone and pressure, or laser alongside injections. For keloids, combining treatments is the norm rather than the exception, because surgery alone so often leads to recurrence. Your clinician will tailor the combination to your scar.
Follow-up & long-term care
Follow-up is usually over several months, because a scar takes a long time to mature and may need a course of treatment. You will be reviewed to remove stitches, check healing, give any planned injections or laser, and assess whether the scar is settling or growing back. You should be told how to care for the scar and who to contact with problems.
- Protect the scar from the sun for at least a year
- Continue silicone, massage or pressure therapy as advised
- Attend repeat injection or laser sessions if planned, especially for keloids
- Watch for any regrowth, particularly with keloid-prone skin, and report it early
Revision and secondary surgery reality
- More than one session or treatment is often needed, especially for raised scars.
- A revised scar can still widen, thicken or, for keloids, come back, sometimes needing further treatment.
- It can take a year or more to judge the final result of a revision.
- Sometimes the honest advice is that no treatment will reliably improve the scar.
Ask your surgeon for their own revision rate, what counts as a revision, and what is included in the written aftercare policy.
What good aftercare looks like
- Honest, written expectations about what improvement is realistic.
- A clear treatment plan, including the number of sessions and follow-up over months.
- Advice on sun protection, silicone and massage to help the scar settle.
- A plan for monitoring and managing recurrence, especially for keloids.
- A named contact for problems such as infection or regrowth.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- Whether treatment is surgical, non-surgical, or a combination
- The size, type and site of the scar (keloids often need more, longer treatment)
- The number of sessions needed (injections, laser or pressure therapy)
- Local anaesthetic, sedation or general anaesthetic, and facility fees for surgery
- Materials such as silicone products or pressure garments
- Follow-up appointments over many months
- The clinician's fee and which treatment(s) it covers
- Whether a course of sessions is included or charged each time
- Anaesthetic or sedation fees if surgery is involved
- Facility or theatre fees
- Materials such as silicone or pressure garments
- Follow-up appointments over the months it takes to settle
- What happens, and what it costs, if the scar does not improve or comes back
On the NHS? Scar revision may be funded on the NHS where a scar affects function or causes symptoms, often after injury or surgery; purely cosmetic revision is usually private, and your GP can advise.
You're entitled to your total cost in writing — including aftercare and any revision — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Implying a scar can be removed completely rather than improved.
- Not warning keloid-prone patients that surgery alone often makes things worse.
- Not explaining that results take many months and may need several sessions.
- Not discussing the chance that the result is no better, or worse.
- No clear plan for follow-up or for managing recurrence.
Marketing red flags
- Promises of complete scar removal or 'erasing' scars.
- Guaranteeing keloids will not come back.
- Before-and-after photos taken at different times, angles or lighting.
- Offering surgery for keloids without a plan to prevent recurrence.
- Pushing expensive treatment courses without explaining realistic benefit.
Choosing a surgeon safely
- Check your surgeon is on the GMC Specialist Register for this area.
- Make sure they practise at a CQC-registered location, and look for membership of bodies like BAAPS or BAPRAS.
- You're entitled to a two-stage consent process with time to reflect (a cooling-off period). The surgeon who will operate must consent you — not a salesperson.
- Be wary of pressure: time-limited offers, discounts or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including aftercare and any revision — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good surgeon will welcome every one of these.
- What type of scar do I have, and what improvement is realistic for it?
- Should I wait for the scar to mature before doing anything?
- Do you recommend surgery, non-surgical treatment, or a combination — and why?
- If I am prone to keloids, how will you reduce the risk of it coming back?
- How many sessions might I need, and how long until I see the final result?
- What happens if the result is no better, or the scar returns?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the surgeon who carries out my operation, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this operation not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Can a scar be completely removed?
How long should I wait before treating a scar?
Why are keloid scars so hard to treat?
Will scar revision get rid of tightness or pulling?
Can I have this on the NHS?
Does treatment work the same on all skin types?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: British Association of Dermatologists — Keloids (patient information) Management of keloid and hypertrophic scars (PMC) Management of keloids and hypertrophic scars: current and emerging options (PMC) Hypertrophic scarring and keloids — StatPearls (NCBI) Wound coverage and adjuvant treatments for major keloid scars: systematic review (PMC) NHS — Scars (types and treatments)
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
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