Clinic for plastic surgery, Belgrade, Serbia


Scar removal surgery


Replacing damaged tissue with new connective tissue – cicatrisation (i.e. scar creation) is the way how every normal skin heals. During that healing process a fine linear scar is created which is hard to see.

Good preoperatively planning of incision is required to achieve the least noticeable scar. Surgical incision is planned so that the final scar lies parallel or just besides relaxing skin tension lines that match wrinkle lines.


If disturbance in wound healing occurs, so called abnormal scars are created which show as 1) wide spread, 2) hypertrophic and 3) keloid


  1. Wide spread scars were presented for the first time in 1987 by Rudolph. They are described by having the precisely same order of collagen fibers as ordinary scars. Clinically typical wide spread scar is flat surfaced, wide and often dented.
  2. Hypertrophic scars are defined as abnormal growth of scar tissue that does not extend beyond the boundary of the original wound. The maturation period lasts from 18 to 24 months.
  3. Keloid scars are defined as scar overgrowth that spreads to skin not affected by original wound.


Before the beginning of scar treatment a following must be determined: diagnosis, scar localization, orientation, width, length, contour irregularity, pigmentation, distortion of anatomical marks and scar age. A clinical differential diagnosis between keloid, hypertrophic or wide spread scar must be established, and only then we can start with scar treatment. Treatment of abnormal scar depends on surgeon's assessment. There are three types of abnormal scar treatment: nonsurgical, surgical and combined.


  1. Treatment of abnormal scar with Contractubex. It exhibits antiproliferative, anti-inflammatory softening effect on proliferative scar tissue. It is applied by gently massaging into skin. It is applied a couple of times a day until all of the gel is absorbed.
  2. Compression treatment. It begins early in the maturation phase by compression using special elastic suite or corset. Compression needs to be constant 24 hours a day for the next 6 to 12 months.
  3. Silicone materials. They can be in the form of a tile (Cica Care) or in a gel form (Dermatix). They have positive results in treatment of hypertrophic scar with treatment that takes 24 hours a day for 6 to 12 months.
  4. Retinoic acid. It inhibits collagen creation and if used locally two times a day for the duration of 1 year, good results are achieved.
  5. Other nonsurgical treatments. Intrascar injection of corticosterioids (Kenalog 10) or interferon, electrophoresis, radiation treatment, hydrotreatment, etc. are used rarely nowadays..


  1. For achieving a good scar it is important to use meticulous surgical technique. Subdermal tissue is sutured in layers by individual stitches, while the skin is sutured with extension intradermal stitch using fine monofilament suture with atraumatic needle. Stitches on the face stay there 5 to 7 days while on the other body parts they stay 12 to 14 days after the procedure.
  2. Skin expansion. Shape of expanders is similar to a balloon. They are made from silicone elastomers in various shapes and sizes. They are connected via thin hose with connector through which saline solution is injected periodically until desired inflation is achieved, and with that a controlled skin surface increase. Excess skin gained by expansion is used for defect reconstruction that secondary occurs on the place of abnormal scar tissue excision.
  3. Laser excision of abnormal scar. This technique has gained earlier great publicity. However today's reports give mixed success, not so good as expected.
  4. Dermabrasion. This technique has no result on wide spread scars. Effect can be achieved through dermabrasion only on uneven and raised scars such as acne scars on the face


Scar removal (microsurgical removal) - from 300€


Some of the patients that were operated on by Dr. Milan Jovanovic personally:

  • scar removal
  • scar revision

Note: All of the results are genuine, without any processing in Photoshop.

Before scar removal After scar removal
Before scar removal | After scar removal

Before scar removal After scar removal
Before scar removal | After scar removal

Before scar removal After scar removal
Before scar removal | After scar removal

Before scar removal After scar removal
Before scar removal | After scar removal

Before scar removal Before scar removal After scar removal
Before scar removal | After scar removal