Facial Scar Revision & Reconstruction in Beverly Hills
Beverly Hills plastic surgeon Elie Ramly, MD, provides surgical and nonsurgical evaluation and treatment of facial scars, including scars following injury, previous surgery, skin lesion removal, Mohs surgery, facelift, rhinoplasty, and other procedures.
Facial scar revision is an individualized surgical or nonsurgical approach to improving scars that remain conspicuous because of their width, orientation, contour, tethering, texture, color, thickness, or relationship to surrounding facial anatomy.
At Ramly Plastic Surgery, treatment is determined by why a scar is noticeable—not simply by which treatments are available.
A Scar Is More Than a Line on the Skin
Facial scars are complex.
A scar may be noticeable because it is wide. Another because it is raised. Another because it is depressed, tethered, discolored, irregular in texture, poorly oriented, or positioned in a way that interrupts the natural contours of the face.
Some scars involve several of these problems simultaneously.
That distinction matters because different scar characteristics require different solutions.
Dr. Ramly approaches facial scar revision by first asking a fundamental question:
Why is this particular scar noticeable?
Only then can the appropriate treatment—or combination of treatments—be considered.
Dr. Ramly's Perspective
“The most important question in scar treatment is often not which procedure to perform, but why the scar is noticeable in the first place.”
What Makes a Facial Scar Noticeable?
The appearance of a scar is influenced by far more than its length.
Dr. Ramly evaluates characteristics including:
Width — A widened scar may contrast with the surrounding skin and become more visible.
Orientation — Scars that cross natural facial creases, aesthetic boundaries, or favorable skin lines may attract more attention.
Contour — A depressed or elevated scar can create highlights and shadows that make it visible even when its color closely matches the surrounding skin.
Tethering — Scar tissue may adhere to deeper structures, creating a depression or distortion that becomes more apparent with facial movement.
Contracture — Some scars shorten or tighten as they heal, potentially distorting nearby anatomy or restricting movement.
Texture — Irregular surface texture can make a scar conspicuous at close range or under directional lighting.
Thickness — Hypertrophic scars, keloids, and other thickened scars may become elevated, firm, symptomatic, or extend beyond the expected boundaries of healing.
Color and vascularity — Persistent redness or differences in pigmentation may draw attention to an otherwise favorable scar.
Volume deficiency — Loss of underlying soft tissue can create a depression around or beneath a scar.
Hair-bearing skin — Scars involving the beard, eyebrow, scalp, sideburn, or hairline may become noticeable because of changes in hair growth or alignment.
Relationship to facial anatomy — A scar crossing an aesthetic subunit, natural crease, eyelid, lip, nose, ear, hairline, or other facial landmark may be particularly visible even when technically well healed.
Understanding these characteristics is the foundation of thoughtful scar treatment.
Facial Scar Revision Is Not About Erasing a Scar
No surgery, laser, injection, cream, or other treatment can make a scar disappear completely.
Surgical scar revision replaces or modifies an existing scar with another healing scar.
The objective is therefore not to create a “scarless” result.
Instead, when revision is appropriate, the goal is to create a scar that may ultimately be narrower, better oriented, less tethered, smoother, better contoured, or more naturally integrated with the surrounding facial anatomy.
For some scars, surgery can offer meaningful improvement.
For others, surgery may accomplish very little—or may create unnecessary additional scarring.
Knowing when not to operate is part of scar treatment.
Surgical Facial Scar Revision
Surgical scar revision may be considered when the architecture of the scar itself is unfavorable.
Depending on the anatomy, treatment may involve excision of an unfavorable scar and meticulous re-closure, release of tethered scar tissue, redistribution or rearrangement of surrounding tissue, correction of contour abnormalities, or other reconstructive techniques.
The appropriate operation depends on the scar.
A short widened scar may require a very different strategy from a long scar crossing natural facial lines. A tethered scar may require treatment beneath the skin rather than simply excising the visible surface. A scar associated with tissue loss may require restoration of volume rather than repeated removal of additional tissue.
For this reason:
Scar revision is not a single procedure.
It is a reconstructive problem requiring an individualized solution.
Z-Plasty, W-Plasty & Scar Reorientation
Simply cutting out a scar and closing the same line again does not necessarily address why that scar was unfavorable in the first place.
In selected scars, techniques such as Z-plasty, W-plasty, geometric broken-line closure, or other local tissue rearrangements may be considered to redirect an unfavorable scar, interrupt a conspicuous straight line, lengthen a scar contracture, redistribute tension, or better integrate a scar with surrounding facial anatomy.
These techniques are not appropriate for every scar.
The choice of scar revision technique depends on the scar's orientation, location, surrounding tissue, tension, facial anatomy, and the problem being corrected.
Scar Orientation & Facial Anatomy
The face is organized into natural contours, creases, junctions, and aesthetic subunits.
Where possible, favorable scars tend to coexist with these structures rather than compete with them.
A scar near the nose, eyelid, lip, ear, hairline, or jawline therefore cannot be evaluated simply by measuring its width.
Its relationship to surrounding anatomy matters.
In selected cases, surgical planning may involve changing the orientation of part of a scar, breaking up a long straight line, repositioning a scar toward a more favorable anatomical boundary, or redistributing tension.
The objective is not simply to create the shortest possible scar.
Sometimes a slightly longer scar positioned more favorably can ultimately be less noticeable than a shorter scar in an unfavorable position.
Tethered & Depressed Facial Scars
Some facial scars appear indented because scar tissue has become adherent to deeper tissues.
These scars may become particularly visible when light passes across the face or when facial expression pulls against the tethered area.
Simply excising the surface scar may not correct the underlying problem.
Depending on the anatomy, treatment may require release of deeper scar attachments, redistribution of surrounding tissue, restoration of volume, or a combination of approaches.
In selected patients, structural fat grafting may also play a role when a scar is associated with underlying soft-tissue deficiency.
The goal is to treat the three-dimensional contour, not merely the line visible on the surface.
Scar Contracture
Scar contracture occurs when scar tissue shortens or tightens in a way that pulls on surrounding tissues.
On the face, even relatively small contractures can become important when they distort a natural crease, eyelid, lip, nose, ear, hairline, or another mobile anatomical structure.
Treatment depends on the location, severity, surrounding tissue, and underlying cause.
Selected contractures may benefit from scar release, tissue rearrangement such as Z-plasty, or other reconstructive techniques designed to restore length and reduce distortion.
The visible scar and the forces beneath it must be considered together.
Raised, Hypertrophic & Keloid Scars
Not every raised scar is the same, and not every raised scar requires surgery.
A hypertrophic scar generally remains within the boundaries of the original injury, while a keloid can grow beyond them. Their behavior, recurrence risk, and appropriate treatment may differ.
Some thickened scars benefit from continued observation as they mature. Others may respond to injectable treatment or other nonsurgical therapies. In selected circumstances, surgical treatment may eventually become appropriate.
A history of hypertrophic scarring or keloid formation is particularly important because removing a problematic scar does not eliminate the biological tendency that contributed to its formation.
Treatment therefore requires careful consideration of scar behavior, location, maturity, previous treatments, symptoms, skin characteristics, and individual healing history.
Facial Scars After Trauma or Laceration
Traumatic facial scars can be particularly complex because the original injury may have affected multiple tissue layers.
A scar following a laceration may involve irregular skin edges, tissue loss, crush injury, underlying muscle, nerves, cartilage, or other structures.
Once healed, the resulting scar may be wide, irregular, depressed, tethered, contracted, poorly oriented, or associated with contour changes.
Revision planning therefore begins with understanding the original injury and identifying which components of the healed result are potentially correctable.
Some traumatic scars may benefit from surgical revision. Others may require resurfacing, volume restoration, laser treatment, or a staged combination of treatments.
Scars After Mole or Skin Lesion Removal
A scar following previous mole or skin lesion removal may be noticeable because of width, depression, pigmentation, contour change, recurrent lesion, or the orientation of the original procedure.
Treatment depends on what remains.
A depressed scar following previous removal may require a different approach from a widened linear scar following excision. A scar associated with underlying volume deficiency may require structural correction rather than simply removing additional skin.
Dr. Ramly evaluates the existing scar, surrounding anatomy, previous procedure, and whether additional diagnostic or dermatologic evaluation is appropriate before recommending treatment.
Scar Revision After Mohs Surgery or Skin Cancer Treatment
Treatment of skin cancer appropriately prioritizes complete oncologic management.
After Mohs surgery or another skin cancer procedure, some patients are left with scars or contour changes that become aesthetically or functionally bothersome after healing.
Depending on the location and anatomy, concerns may include scar width, contour depression, distortion of surrounding structures, asymmetry, tissue deficiency, or conspicuous scar orientation.
Scar revision or reconstruction may sometimes improve these concerns.
When appropriate, Dr. Ramly can coordinate care with the patient's dermatologist or Mohs surgeon so that aesthetic reconstruction remains secondary to appropriate treatment and surveillance of the underlying skin condition.
Scars After Facelift & Neck Lift Surgery
Facelift and neck lift scars are ideally positioned around natural anatomical boundaries of the ear and hairline.
However, patients seeking revision may present with widened scars, displaced hairlines or sideburns, visible preauricular scars, contour irregularities, tethering, pixie-ear deformity, or scars that have become conspicuous because of tension or unfavorable placement.
These concerns cannot always be treated as isolated skin scars.
In some cases, the underlying facial or neck anatomy—and the forces responsible for the scar—must also be considered.
Dr. Ramly's practice focuses extensively on facelift, neck lift, and revision facial surgery, allowing scar concerns following previous facial rejuvenation to be evaluated in the context of the operation that created them.
Scars After Rhinoplasty
External rhinoplasty incisions generally heal favorably, but occasionally a patient may develop a conspicuous columellar or other nasal scar.
The nose presents unique reconstructive considerations because the skin envelope is closely related to underlying cartilage, contour, nasal subunits, and airway structures.
Treatment depends on whether the concern involves scar width, thickness, pigmentation, contour, tethering, or distortion of the surrounding nasal anatomy.
For some patients, observation or nonsurgical treatment is preferable to additional surgery.
When Is the Best Time to Revise a Facial Scar?
There is no single timeline that applies to every scar.
Scars evolve considerably during healing. Early scars may appear red, firm, elevated, or more noticeable before gradually softening and fading.
For many scars, allowing appropriate maturation before considering surgical revision is beneficial.
However, timing depends on the underlying problem. Certain functional distortions, unfavorable contractures, or other circumstances may warrant earlier intervention.
The appropriate timing therefore depends on the scar, its location, stage of healing, symptoms, underlying anatomy, and proposed treatment.
A scar being visible does not necessarily mean it is ready to be revised.
Surgery Is Only One Tool
One of the most important principles of scar treatment is recognizing when not to operate.
Depending on what makes a scar noticeable, treatment may include:
Surgical scar revision for unfavorable scar architecture, width, orientation, or selected contour problems.
Scar release for tethering to deeper tissues.
Structural fat grafting for selected volume deficiencies or contour abnormalities.
Microneedling or resurfacing for selected textural concerns.
Injectable treatment for selected thickened or symptomatic scars.
Laser treatment for selected vascular, pigmentary, textural, or other scar characteristics.
Electrolysis when unwanted hair contributes to the appearance of a scar or reconstruction.
Medical scar camouflage for selected mature color differences that cannot be adequately corrected by other approaches.
Sometimes the most appropriate treatment is simply additional time.
When Is Surgery Better Than Laser for a Facial Scar?
Surgery and laser treatment solve different problems.
Laser treatment may be valuable for selected scar characteristics such as redness, pigmentation, texture, or thickness.
However, laser cannot necessarily correct significant scar width, unfavorable orientation, deep tethering, missing tissue, scar contracture, or distortion of surrounding facial anatomy.
Conversely, surgery cannot automatically correct every difference in color, vascularity, or surface texture.
For complex scars, the best strategy may therefore involve a thoughtful sequence of treatments rather than trying to make one modality solve every problem.
Can Scar Revision, Laser, Microneedling, Injectables & Fat Grafting Be Combined?
Yes. Selected complex facial scars may benefit from more than one treatment modality.
For example, surgery may improve scar position or tethering while later treatment addresses persistent redness or texture. Scar release may improve a depression while structural fat grafting restores surrounding volume. A mature scar with residual color mismatch may ultimately benefit from medical camouflage.
These treatments are not necessarily performed simultaneously.
The sequence should reflect the anatomy, scar biology, previous treatment, and stage of healing.
The goal is not to perform every available treatment. It is to determine which treatment—or thoughtful combination of treatments—offers the most appropriate path forward.
A Reconstructive Approach to Facial Scars
Scar revision sits at the intersection of aesthetic and reconstructive plastic surgery.
Dr. Ramly's background in plastic and reconstructive surgery and advanced fellowship training in facial transplantation informs an approach that considers the entire reconstructive problem—including skin, soft tissue, volume, contour, facial subunits, movement, and surrounding anatomy—not simply the visible line at the skin surface.
His practice is centered on aesthetic and reconstructive facial surgery, including facelift and neck lift surgery, rhinoplasty, revision facial surgery, facial fat grafting, and comprehensive facial rejuvenation.
Those same principles inform his approach to facial scars.
Scar treatment requires attention to anatomy, proportion, tissue handling, tension, incision placement, facial contours, volume, movement, and healing.
Sometimes the problem is measured in centimeters.
Sometimes it is measured in millimeters.
The size of the scar does not determine the amount of thought it deserves.
Coordinated Scar Care
No single physician or technology is ideally suited to every characteristic of every scar.
When appropriate, Dr. Ramly can coordinate care with trusted specialists in dermatology, laser treatment, electrolysis, and medical scar camouflage.
This can be particularly valuable for complex scars involving several different problems—for example, contour irregularity combined with redness, pigmentation, unwanted hair, or color mismatch.
The treatment plan is built around the scar rather than around the capabilities of any single device or office.
Facial Scar Revision in Beverly Hills & Los Angeles
Dr. Elie Ramly evaluates facial scars at Ramly Plastic Surgery in Beverly Hills for patients from Beverly Hills, greater Los Angeles, Southern California, and beyond.
Depending on the characteristics of the scar, treatment may include surgical scar revision, scar release or tissue rearrangement, structural fat grafting, microneedling, chemical resurfacing, injectable treatment, or coordinated treatment with specialists in dermatology, laser therapy, electrolysis, or medical scar camouflage.
The appropriate treatment begins with determining why the scar is noticeable and which aspects of it can realistically be improved.
Frequently Asked Questions About Facial Scar Revision
Can a Plastic Surgeon Completely Remove a Facial Scar?
No. A scar cannot be completely erased. Surgical scar revision creates another healing scar.
The goal is to replace or modify an unfavorable scar so that it may ultimately become less conspicuous or better integrated with the surrounding anatomy.
Who Is a Good Candidate for Facial Scar Revision?
Potential candidates include patients with scars that remain bothersome because of width, orientation, contour, tethering, contracture, thickness, texture, or distortion of surrounding anatomy.
Candidacy depends on the individual scar, healing history, medical factors, expectations, and whether treatment is reasonably likely to offer meaningful improvement.
Can an Old Facial Scar Still Be Revised?
Yes. Some mature scars can potentially be improved even many years after the original injury or surgery.
The age of a scar is only one consideration. More important is why the scar is noticeable and whether that characteristic can reasonably be improved.
Is Facial Scar Revision Performed Under Local Anesthesia?
Many selected facial scar revisions can be performed under local anesthesia in the office.
More complex reconstruction or scar treatment performed as part of another facial operation may require a different setting or form of anesthesia.
How Long Does a Revised Facial Scar Take to Heal?
Initial skin healing occurs much earlier than final scar maturation.
A revised scar typically continues changing for many months as redness, firmness, thickness, and visibility evolve. The specific course varies according to location, procedure, skin characteristics, tension, postoperative care, and individual healing.
Can Laser Replace Surgical Scar Revision?
Sometimes laser is the more appropriate treatment; sometimes surgery is.
They address different scar characteristics.
Laser generally cannot correct significant scar width, unfavorable orientation, deep tethering, contracture, or major tissue deficiency, while surgery may not adequately address persistent redness, pigmentation, or certain textural problems.
Can Fat Grafting Improve a Facial Scar?
In selected patients, structural fat grafting may help address volume deficiency, depression, or contour irregularity associated with a scar.
It is not appropriate for every scar and may sometimes be combined with scar release or other treatment.
What Is the Difference Between a Hypertrophic Scar and a Keloid?
Both can appear raised or thickened, but they behave differently.
Hypertrophic scars generally remain within the boundaries of the original injury, while keloids can extend beyond those boundaries. Correctly characterizing a raised scar matters because treatment strategy and recurrence risk may differ.
Can Scar Revision Make a Scar Worse?
Any intervention creates risk, and scar revision cannot guarantee a better scar.
Potential problems include recurrent widening, unfavorable pigmentation, hypertrophic or keloid scarring, contour irregularity, infection, wound-healing problems, and dissatisfaction with the degree of improvement.
Careful patient selection, appropriate technique, postoperative care, and realistic expectations are therefore essential.
Where Can I Get Facial Scar Revision in Beverly Hills or Los Angeles?
Dr. Elie Ramly evaluates facial scars at Ramly Plastic Surgery in Beverly Hills.
His approach combines aesthetic and reconstructive facial surgery principles with surgical and nonsurgical scar treatment. Depending on the individual problem, treatment may include surgical scar revision, scar release, tissue rearrangement, structural fat grafting, microneedling, chemical resurfacing, injectable treatment, or coordinated care with specialists in laser treatment, dermatology, electrolysis, or medical scar camouflage.
Elie Ramly, MD
Elie Ramly, MD is a Harvard-trained plastic surgeon in Beverly Hills whose practice focuses on aesthetic and reconstructive facial surgery, including facelift and neck lift surgery, rhinoplasty, revision facial surgery, facial fat grafting, and comprehensive facial rejuvenation.
Dr. Ramly completed advanced plastic and reconstructive surgery training at Harvard Medical School's Mass General Brigham program and advanced fellowship training in facial transplantation at NYU Langone Health.
His academic work includes extensive peer-reviewed research in plastic surgery, facial surgery, transplantation, and reconstruction.
His approach to facial scar revision combines reconstructive principles with careful attention to facial anatomy, contour, proportion, movement, and the long-term appearance of the resulting scar.
Request a Facial Scar Evaluation
If you have a facial scar following previous surgery, injury, skin lesion removal, Mohs surgery, facelift, rhinoplasty, or another procedure, you may submit photographs and a brief description for preliminary review.
Please include:
Where the scar is located
How the scar occurred
Approximately how old it is
Any previous scar treatments
What specifically bothers you about its appearance or symptoms
Clear photographs of the scar and surrounding facial anatomy
Photographs can assist with preliminary screening and scheduling but cannot establish a diagnosis or determine whether scar revision is appropriate.
An in-person examination is required before a definitive treatment recommendation can be made.
REQUEST A FACIAL SCAR EVALUATION
Ramly Plastic Surgery
414 N. Camden Drive, Suite 800
Beverly Hills, California 90210
Written and medically reviewed by Elie Ramly, MD
Plastic and Reconstructive Surgeon
Beverly Hills, California
Last updated September 2026