Scar Removal Surgery

1. Physical examination: Most scars can be identified physically. The doctor will evaluate the skin that has healed from an injury, burn, trauma, or surgery. The size, color, and texture of the scar are assessed by the doctor to determine its type.
2. Vancouver Scar Scale (VSS): This scale is used to assess the vascularity, thickness, height, pliability, and pigmentation of a burn scar.
3. Manchester Scar Scale (MSS): The scores of different parameters, like the color, skin texture, relationship to the surrounding skin, size, margins, and the number of scars can be assessed using this scale.
4. Visual Analog Scale (VAS): This is a photograph-based scale used to assess the vascularity, pigmentation, observer comfort, acceptability, and contour of the scar.
5. Stony Brook Scar Evaluation Scale (SBSES): This scale can be used to assess how a scar is likely to respond to short-term treatment.
6. Patient and Observer Scar Assessment Scale (POSAS): The scar tissue is evaluated from the perspective of the patient and observer. The pigmentation, thickness, vascularity, relief, pliability, and surface area of the scar can be assessed using this scale. The different symptoms of the patient, like pain, color, stiffness, thickness, and relief, are also incorporated in this scale.

The treatment for scars will depend on many factors like the size, type, location, and duration of scars. The different types of scar treatments include:

1. Topical treatments: The application of topical creams and ointments like cocoa buttercream, silicone gel or lotion, Vitamin E, and onion extract products may help in healing the scars.
2. Steroid injections: Steroid injections can help in flattening the scars. They help in softening the scar appearance, especially hypertrophic and keloid scars. Bleomycin and 5-fluorouracil (5-FU) are normally injected into the scars to flatten them and ease the pain and itchiness associated with scars.
3. Filler injections: These injections help in raising the sunken scars to the level of the surrounding skin. This is a temporary type of treatment and may need frequent repetition.
4. Pressure therapy: An elastic bandage, stocking, or dressing may be used to put pressure on a wound during the healing process. This pressure will prevent scar formation or decrease the size of a scar.
5. Radiotherapy: Superficial, low-dose radiation therapy helps in preventing the recurrence of severe hypertrophic and keloid scars. This treatment is only used for severe scarring as it has long-term side effects.
6. Dermabrasion: This procedure involves the removal of the top layer of the skin using special equipment. It helps in softening and smoothening the skin, as well as improving the appearance of the scars.
7. Microneedling: This procedure involves making small puncture holes in the superficial skin to stimulate the production of collagen and improve the appearance of scars.
8. Cryosurgery: This procedure will involve freezing the scar to reduce its size and relieve the symptoms of pain and itchiness.
9. Laser treatments: A particular wavelength of light is used to make the scars appear less noticeable. The Fraxel and V beam lasers are used to improve the appearance of scars and ease the pain and itchiness associated with scars.
10. Scar-revision surgery: Different types of surgical procedures can help in removing a scar and improving its appearance. Sometimes, surgery may be performed to transplant a skin graft from another area to the scarred area. Surgery is not recommended in keloid or hypertrophic scarring due to an increased risk of recurrence and severe scarring due to treatment.

The complications of too much scar tissue may involve the following:

1. Increased risk of re-injury
2. Strangulation of vital organs
3. Pain
4. Reduced function and mobility of tissue, joint, or organ
5. Inflammation
6. Cancer (rare)

The complications associated with scar removal surgery may include the following:

1. Poor healing
2. Graft failure
3. Bleeding
4. Infection
5. Hypersensitivity
6. Loss of sensation in the treatment area
7. Suture marks
8. Graft tissue contraction 

Home remedies:

Several home remedies can help in improving the appearance of scars. These home remedies may include:

1. Application of Aloe Vera gel directly to the scar region, twice a day.
2. Massage Vitamin E oil on and around the scar area, three times a day.
3. Cover the scar with a layer of honey and wrap it in a bandage every night before going to bed. Remove the bandage in the morning and wash off the honey using warm water.
4. Massage warm coconut oil on the scar area, two to four times a day.
5. Generously dab your scar with a cotton ball dipped in water and apple cider vinegar mixture every night before going to bed and wash the area in the morning.
6. Mix three drops of lavender oil into three tablespoons of olive oil and massage the scarred area three times a day.
7. Topical application of lemon on the scar tissue can help in reducing the appearance of the scar tissue.
8. Rub a potato slice on the scar area and rinse the area later using cool water.
9. Massage the scar area using equal portions of rosehip essential oil and frankincense essential oil.
10. Wet the scar using distilled water and then apply a paste of baking soda on it to wet the scar. Hold this paste in place using a warm compress for fifteen minutes and then rinse the area.

Prevention:

1. Although scar formation cannot be prevented, few measures can be taken to reduce the risk of scarring. These measures include:
2. Visit a doctor immediately if you have a wound that leaves the scar to get stitches or a bandage applied to hold the skin together while healing
3. Wash the scar area using a mild soap to clean out any dirt or dried blood, followed by the application of a clean bandage
4. Apply petroleum jelly to prevent drying of the wound and scan formation
5. Protect the scar from direct sunlight
6. Take a high protein and vitamin-rich diet to help the skin heal

Cost:

The cost of creams and ointments used for scar treatment in India is between INR 300 to INR 2,000.
The cost of non-surgical scar removal treatments, like microneedling, dermabrasion, chemical peels, and laser treatment, in India is between INR 3,000 to INR 30,000 per treatment session.
The cost of dermal filler injections in India is between INR 20,000 to INR 1,00,000 per session.

The cost of scar-revision surgery in Mumbai is between INR 40,000 to INR 1,20,000.

The cost of scar-revision surgery in Delhi is between INR 35,000 to INR 1,10,000.
The cost of scar-revision surgery in Bangalore is between INR 35,000 to INR 1,10,000.
The cost of scar-revision surgery in Chennai is between INR 30,000 to INR 1,00,000.