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Children's Hospital of Pittsburgh
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Children's Hospital of Pittsburgh

Scar Revision Surgery

Scars are a normal part of the body’s healing process. Whether they are caused by birth defects, burns, traumatic injuries, or surgery, scars can occur anywhere on your body — inside and out.

Scars come in many shapes and sizes. Some are small and nearly invisible, while others may be large and painful. They can restrict movement, limit function, and cause emotional distress. The goals of scar revision surgery on children are to restore movement and function (reconstructive) and to improve appearance (aesthetic). Parents should discuss their child’s scar treatment options with a board-certified pediatric plastic surgeon who can offer realistic expectations for the outcome.

The pediatric plastic surgery team at UPMC Children’s Hospital of Pittsburgh provides the most advanced and effective procedures based on best practices to treat your child’s scar. Our surgeries are based on years of clinical experience, research, and best practices.

We treat several types of unfavorable scars:

Unfavorable scars: Can occur at any time. They can be any shape or color, but usually lie in an unfavorable location which can impair function, cause pain, and lead to emotional discress.

Hypertrophic scars: Typically occur within weeks after the initial injury. These scars can be flat or slightly raised and are confined to the same area as the original wound. Hypertropic scars are usually pink or red and can be uncomfortable and itchy.

Keloid scars: Can develop up to a year after the original injury. A type of smooth, firm raised scar, keloids result from abnormal wound healing. Usually purplish-red in color, keloids can grow much larger than the original injury that caused the scar and don’t fade with time. Depending on the location, keloids can limit movement or affect limb growth in children.

At Children’s, we believe parents and guardians can contribute to the success of this surgery and invite you to participate. The following information can help you learn about the surgery and how you can help.

Why Choose UPMC Children’s for Your Child’s Scar Revision?

UPMC Children Hospital of Pittsburgh is a leading pediatric referral facility and treats patients from around the region. It also is western Pennsylvania's only Level-1 Pediatric Trauma Center. Whether your child’s situation is severe or straightforward, a congenital impairment, or the result of an injury or trauma, we take care of the whole spectrum, applying our years of expertise, knowledge, and experience to help your child — and every single patient we treat.

Fast Facts About Scar Revision Therapy

  • Scar revision surgery is a highly individualized procedure. Our board-certified pediatric plastic surgeons will develop and execute the safest and most effective treatment plan for your child.
  • Most scar revision procedures are done as same-day surgery, which means your child will come into the hospital and go home the same day. If a procedure is more complex, your child may have to stay overnight in the hospital.
  • Scar revision surgery usually occurs at least 6 months after an injury or after the original scar has had a chance to fully mature/heal. With keloid scars, surgery may not be considered for one or two years after the initial injury.
  • Not all scars can be improved with surgery, and scars cannot be completely removed.

One business day before your child’s surgery, you’ll receive a phone call from a nurse between the hours of 1 and 9 p.m. (Nurses do not make these calls on weekends or holidays.) The nurse will give you specific eating and drinking instructions for your child based on their age.

Your child’s scar revision surgery will be done at the Same Day Surgery Center at Children’s Hospital in Lawrenceville or Children’s North Surgery Center in Franklin Park.

When you have checked in, you and your child will be called to an examination room where your child’s health history will be taken and vital signs will be checked. You’ll meet with one of the doctors, including a doctor from anesthesia, on your child’s surgical team to go over the surgery. They will answer any last-minute questions you might have.

When it is time for your child to go the operating room, you’ll be asked to wait in the surgical family waiting area.

The most important role of a parent or guardian is to help your child stay calm and relaxed before the surgery. The best way to do that is to stay calm yourself.

During the surgery, at least one parent or guardian should remain in the surgical family waiting area at all times.

While your child is asleep, their heart rate, blood pressure, temperature and blood oxygen level will be checked continuously. When the surgery is over, the medicines will be stopped and your child will begin to wake up.

When your child is moved to the recovery room, you’ll be called so that you can be there as they wake up. You and your child will stay in the recovery room to be watched over until they are alert and drinking well.

Children coming out of anesthesia may react in different ways. Your child may cry, be fussy or confused, feel sick to the stomach, or vomit. These reactions are normal and will go away as the anesthesia wears off.

A complete list of instructions for taking care of your child at home will be given to you before you leave the hospital.

If your child has sutures (stitches):

  • Stitches will be removed at your child’s first follow-up visit.
  • Your surgeon will tell you when your child can resume normal daily activities. IMPORTANT: No contact sports for at least 4 weeks.

If your child has Dermabond (a surgical glue that is shiny and a purplish color):

  • Do not submerge the surgical site under water for 2 to 3 weeks after surgery.
  • Showers are okay beginning the day after surgery.
  • Dermabond will come off on its own; normally it is in place for 1 to 2 weeks.
  • Your surgeon will tell you when your child can resume their normal daily activities. IMPORTANT: No contact sports for at least 4 weeks

Pain Management

After surgery, your child can take acetaminophen (Tylenol) for any discomfort. We can help with dosing if you are unsure. If Tylenol doesn’t seem to be working, you may also use ibuprofen (Motrin/Advil) — but only if your child is age-appropriate and has no kidney restrictions. Tylenol and Motrin can be used together as needed. Use a calendar to keep the dosing schedule straight. You can decrease the use of pain medicine as your child’s pain improves.

IMPORTANT: Please let us know if your child has a sensitivity or allergy to any of these medicines or has kidney or liver problems.

Have your child eat lightly for the first meal after surgery. They should then be able to eat or drink as normal.

It is unlikely that antibiotics will be needed after surgery.

While your child is recovering at home, we’re happy to discuss any concerns with you. Here’s how to reach us:

Weekdays: Call 412-692-6845 between 7:30 a.m. to 3:30 p.m. to reach the nurse.
Evenings & Weekends: Call the 412-692-5325 (hospital operator) and ask to speak to the on-call plastic surgery doctor.

If you notice any of the following changes in your child, please call the nurse or on-call plastic surgery doctor immediately:

  • Fever higher than 101.4 F
  • Trouble breathing, or skin color changes (pale, blue, or gray)
  • Bleeding
  • Eating or drinking less than normal
  • Decreased urine
  • Vomiting

Contact Us

To schedule an appointment with the Division of Pediatric Plastic Surgery, call 412-692-8650. Online scheduling is also available for both in-person and video visits.