Is surgical excision needed before scar revision surgery?

Scar revision surgery is planned around the scar's width, direction, tightness, depth, colour and position. In some cases, the revision involves removing the old scar and closing the wound carefully in the same operation. In others, a non-excisional approach may be more suitable, such as improving tension, releasing a contracture or combining surgery with another treatment.

A separate excision may be considered when tissue needs diagnosis, when a lesion remains, or when staged reconstruction is safer for the area. Excision can create another wound, so its purpose and timing should be clear before consent.

Bring details about the original injury or operation, prior treatments, changes in the scar and any history of poor healing or raised scars. Ask whether the proposed plan includes [Surgical Excision](/treatments/surgical-dermatology/excisional-surgery/) or is a different form of [Scar Revision Surgery](/treatments/surgical-dermatology/scar-revision-surgery/). Follow instructions about medicines, smoking, wound care and activity.

Before planned surgery, report a scar that is rapidly enlarging, ulcerated, bleeding, persistently painful or changing in colour. After surgery, contact the team for increasing redness, warmth, swelling, wound separation, pus, fever or pain that is not controlled. Sudden breathing difficulty or facial swelling needs urgent care.

Ask what tissue will be removed, whether it will be sent for examination, and whether excision happens during the revision or at another stage. Discuss closure method, anaesthesia, recurrence of raised scarring, wound care, activity limits and what improvement is realistic for your scar.