Surgical scar revision against relaxed skin tension lines–Achieving robust esthetic outcomes while swimming against the tide: A retrospective study

Objectives: The aim of this article is to examine cosmetic outcomes in facial scar revisions performed against relaxed skin tension lines (RSTL) by adding buried non-absorbable intradermal material (6-0 polyamide black) as the initial closure step of the wound, followed by pertinent cutaneous closure techniques. Material and Methods: We collected data from a total of 53 patients who had undergone surgical scar revisions against RSTL, randomly and retrospectively. We used two different parameters to gauge post-surgical improvement–visual analog scale (VAS) for overall aesthetic outcome as the patient-reported outcome and modified Vancouver scar scale (mVSS) as the physician-reported outcome. The scale of VAS was from 10 to 0 (10 being the worst the scar can look and 0 being the best). VAS and mVSS were compared pre and postoperatively at 6 months. Comparison was done using a paired t -test, and p <0.05 was considered significant. Results: The male-to-female ratio was almost 1:1 (26 males, 27 females), with a mean age of 29.02 ± 10.752 years. The most common site involved was forehead (29.8%), followed by nose and cheeks (22.8% each). The improvements in the mean VAS and mVSS were found to be statistically significant ( p <0.001). Conclusion: We can hereby deduce that robust cosmetic outcomes can be obtained even when performing scar revisions against RSTL, in selected cases, by merely adding strength withan intradermal stitch.