Scar Revision

Scars are a normal part of the healing process but can be unsightly and uncomfortable. Whether due to injury, surgery or acne, visible scars can affect how you feel about yourself. 

As a board-certified oral and maxillofacial surgeon and Fellow of the American College of Surgeons (FACS), Dr. John P Freeman is highly skilled in scar revision surgery as well as minimally invasive scar revision procedures. Dr. Freeman offers patients several treatment modalities for unsightly scars and takes an individualized approach to provide the best possible outcomes.

What Is Scar Revision?

Scar revision refers to surgery to reduce or improve the appearance of a scar. There are also nonsurgical treatments for scar revision. 

A scar revision procedure aims to make the scar less conspicuous so that it blends with the surrounding skin. This can be done through surgery, mechanical skin resurfacing, laser treatments and even topical treatments. Which one of these approaches will work best for you depends on the severity of your scar and its location, as well as your skin type and overall health. 

Why Undergo Scar Revision?

Your skin is the largest organ in your body, and in many ways, it is quite resilient. However, a tear in its surface can sometimes result in visible damage. As your body heals a wound, scarring naturally occurs. Even the smallest facial scars can be enough to make us feel self-conscious. 

While many might believe they have to endure the psychologically and aesthetically debilitating effects of scars resulting from acne, burns or accidents, scar revision provides relief. Dr. Freeman offers highly effective surgical and nonsurgical solutions to minimize the visibility of facial scars.

Types of Scars

Scars come in different shapes, sizes and colors. Prominent scars often occur as a result of poor wound healing, but unsightly scars can happen without a known reason. Examples of the scars Dr. Freeman often sees in his office include: 

Keloid scars

A keloid is a thick and raised scar. It can be itchy and painful and even impair movement if occurring near a joint. Keloid scars are characterized by overproduction of collagen, with the scar growing even after the wound has healed. 

Hypertrophic scars

Hypertrophic scars are similar to keloid scars in appearance. But unlike keloid scars, they do not grow beyond the perimeter of the wound. Hypertrophic scars may gradually improve after a few years. 

Ice pick scars

Cystic acne and chickenpox can cause ice pick scars. These scars have a sunken or pitted appearance and are due to underproduction of collagen. Ice pick scars can be particularly concerning to patients because they appear on the cheeks and are thus quite visible. 

There are also scar contractures, discolored scars and normal scars that blend into the surrounding skin. No matter which type of scar you’re dealing with, there is a treatment that can work. At his Katy, TX office, Dr. Freeman often uses a combination of different treatments. Patients are advised to maintain reasonable expectations and keep in mind that complete removal of a scar may not be possible. 

Scar Revision Procedures

Dr. Freeman will suggest the best approach for your unique case during your consultation. He will make his decision based on evaluating your scar and the surrounding skin.

Surgical Excision 

Large hypertrophic or keloid scars are usually treated with surgery. Dr. Freeman excises the scar then carefully closes the incision to create a thin, less visible scar in its place. If the scar covers a large area of skin, Dr. Freeman may need to rotate more of the surrounding skin to replace missing tissue. Surgical excision is the most invasive scar revision technique.

Microneedling With PRF

Microneedling is a minimally invasive cosmetic procedure that involves pricking the skin with very fine needles to boost collagen production. PRF stands for Platelet Rich Fibrin, which is a component of your own blood that aids the healing process. Microneedling with PRF is an ideal option for patients with post-acne ice pick scars who wish to even out their skin texture and tone. It is also used to improve hypertrophic scars.


Dermabrasion is essentially a type of deep exfoliation. It is used to remove dead or damaged skin cells, which are replaced with new cells during healing. A small, motorized device with a rough surface is moved across your skin to “sand” the surface of your skin. The procedure can be used on acne scars or scars from surgery. There is some downtime with this procedure and IV sedation may be required to maintain your comfort.

Laser Resurfacing

Dr. Freeman uses a carbon dioxide (CO2) laser to remove burn or trauma scars. It is also an effective treatment option for acne and hypertrophic scars. The laser beam destroys the outer layers of the skin, which stimulates the healing process so that new skin starts to form. The CO2 laser offers surgeons a great deal of precision as it does not damage healthy tissue around the scar. 

Chemical Peels

Chemical peels are a great solution for mild acne scars. At our office, we mainly use the 30% TCA Jessner’s Peel, a medium-depth peel. The addition of Jessner’s solution to a TCA peel allows for deeper penetration of the skin and thus more dramatic results. As a strong form of exfoliation, chemical peels come with some downtime and may need to be repeated several times before we can achieve the desired results.

ZO® Skin Health

Created by leading dermatologist Dr. Zein Obagi, the ZO® Skin Health line of products includes preparations to prevent scarring or boost skin recovery. Some of their products are only available via prescription, which you can get at our office in Katy, TX. 

Schedule A Consultation

Call 281-599-9445 today to schedule your in-person consultation with Dr. John P. Freeman and take a step closer to the even and radiant skin you deserve!


How soon can scar revision be done?

Many scars become less visible over time, which is why Dr. Freeman advises patients to wait one year before considering scar reduction. However, this depends on the type of scar, as some benefit from early treatment. If you have active acne, you will need to treat this problem first to prevent further scarring and minimize the risk of complications.

Does scar revision really work?

Scar revision usually leads to a noticeable reduction in the scar. This is particularly true for superficial and uncomplicated scars. Hypertrophic and especially keloid scars may be more complicated to treat, with the scars sometimes recurring after treatment. 

Are there any risks with scar revision?

Scar revision surgery is generally safe, but there is always a risk of bleeding, bruising, infection and reactions to drugs used during treatment. Less invasive scar revision procedures come with their own set of risks, but they are unlikely to happen when a skilled and board-certified surgeon does the treatment. 

What is the success rate for scar revisions?

According to a 2015 study involving 250 scar revision patients, the satisfaction rate was around 80 percent. Most of the interviewed patients reported that their scars appeared better following surgery. 

Is scar revision covered by insurance?

Most scar revisions are performed for cosmetic purposes and are not eligible for insurance coverage.