Scar Revision

Scar revision at MUDr. Šimek's Olomouc practice addresses both functional scars (those restricting movement) and aesthetic scars (those visible or distressing to the patient). MUDr. Šimek is direct about the limits of scar treatment: 'Scars cannot be eliminated' is the clinic's explicit starting position — realistic expectation-setting is a professional responsibility. What revision can achieve is repositioning, reshaping, narrowing, or re-orienting a scar to make it less noticeable, or releasing a scar contracture to restore mobility. The clinic treats many scar claims made for laser therapy as marketing misconceptions. Earlobe repair is offered separately from 4 000 Kč.

Scars are the end product of the wound healing process — a biological necessity for restoring tissue integrity. The quality of scar formation is determined by a complex interplay of wound tension, infection risk, individual genetic healing tendency, location on the body, and how the original wound was closed and managed. Scar revision surgery does not eliminate scars; it replaces an unfavourable scar with a more favourable one through a second controlled healing process. MUDr. Šimek's clinic states this plainly in its patient documentation, and it is a philosophically important distinction. Many commercial scar treatments — particularly laser systems — are marketed with before-and-after results that reflect natural scar maturation rather than laser efficacy. The clinic specifically describes laser scar claims as 'marketing misconceptions' and bases its treatments on surgical technique and evidence-based scar management protocols. **Functional scar revision** Scars crossing a joint or skin fold may contract over time and restrict movement — called a scar contracture. This is most common after burn injury but occurs after any wound healing across a flexion crease. Surgical revision of contracture scars uses flap techniques (Z-plasty, W-plasty, or local rotational flaps) to interrupt the linear scar and redirect tension away from the joint, restoring range of motion. This category of scar revision is medically indicated, not merely aesthetic. **Aesthetic scar revision** Scars that are wide, raised (hypertrophic), pigmented, or poorly oriented relative to skin tension lines are addressed through excision of the existing scar and meticulous re-closure. The goals: narrower scar width (by ensuring tension-free wound edges), better orientation (using Langer's line principles), and improved surface regularity. Adjunct techniques — dermabrasion, scar resurfacing — may be used at the time of revision or as a second-stage procedure. **Scar maturation and timing** Most scars mature — reaching their final colour, width, and pliability — over approximately 12 months. Facial scars often mature faster, at approximately 6 months. MUDr. Šimek's practice generally advises waiting until scar maturation is complete before performing revision, except in cases of contracture where delayed treatment worsens the functional deficit. Operating on an immature scar (before 12 months for body scars) risks a second hypervascular healing response that may produce a scar comparable to or worse than the first. **Aftercare philosophy** Neutral fats (pork lard, olive oil) applied to the healing scar from suture removal are the clinic's recommended post-revision scar care. UV protection is mandatory for at least 6 months. The clinic does not routinely recommend silicone gel or sheet products — though these may be used as an adjunct when patients request them — preferring the clinical simplicity and cost-effectiveness of neutral fat massage for the scar remodelling phase. **Earlobe repair** Dilated or torn earlobes from heavy earrings, trauma, or gauge stretching are repaired under local anaesthesia from 4 000 Kč — a separate line item priced above the standard scar revision minimum because of the specific closure technique required to maintain or restore the earlobe shape.