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Scar revision surgery - changing shape, tension and direction.

Surgical re-work of a widened, mis-aligned, contracted or bulky scar - Z-plasty, W-plasty, geometric broken-line closure, contracture release and re-excision. Consultant plastic surgeon-led. For non-surgical modalities, see our scar treatment page.

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A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What private scar revision surgery costs in the UK.

Indicative ranges across UK units.

In short

£1,600–£3,500, home the same day.

Procedure Indicative range
Small scar re-excision (under 3 cm, face or body) £850–£1,800
Facial Z-plasty or W-plasty £1,600–£3,500
Large or multiple-Z scar revision £2,800–£5,500
Contracture release with skin graft £4,500–£9,000
Contracture release with local flap £5,500–£11,000
Hair-bearing scar excision (scalp, brow, beard) £1,800–£4,500
Follicular unit hair transplantation into scar £3,500–£8,500
Plastic surgery consultation only £250–£400

Prices vary by hospital, by the consultant, by scar size, technique (excision, Z-plasty, contracture release), and by whether local anaesthetic in clinic or theatre with GA is required.

The problem

Scar revision is where timing and technique both quietly go wrong.

Revising too early makes a scar worse. Revising with the wrong technique makes it more visible. We wait, then match technique to tension line.

  • Wait for maturity, unless a contracture demands otherwise

    Most revisions land better at 12 months. The exception is a contracture pulling on a joint or facial border - earlier release is right there.

  • Direction beats depth

    The commonest revision failure is re-cutting the same line in the same direction. Z-plasty and W-plasty change direction - that is the point.

  • Post-op adjuncts are half the result

    Silicone from week 2, vascular laser at 6 weeks, steroid injection if hypertrophic - planned before surgery, not improvised after.

When it helps

When scar revision surgery is the right step.

The situations we see most, plus one red flag that means specialist review urgently rather than a routine booking.

  • A scar pulled off the natural crease

    A scar that crosses a facial line at an unfavourable angle - Z-plasty rotates the axis 30–90 degrees onto a relaxed skin-tension line.

  • A widened or stretched scar

    A scar spread over months by tension - re-excision with layered closure and long-term tension offloading (tape, silicone) narrows it.

  • A trapdoor or pin-cushioned scar

    A U-shaped scar with tissue bulging inside it - revision breaks the curve with W-plasty and thins the underlying tissue.

  • A contracted scar limiting movement

    A neck, axilla, elbow, hand or joint scar restricting range - contracture release with Z-plasty, local flap or full-thickness skin graft.

  • A stepped or misaligned scar

    A scar with a step-off across a lip, eyebrow or hairline - precise re-alignment restores the border first.

  • Hair loss in a scalp or brow scar

    Excision of an untreatable strip scar, or follicular-unit hair transplantation into scar tissue to restore hair density.

  • Stable hypertrophic scar failing conservative care

    A raised, red hypertrophic scar that has not responded to 6–12 months of silicone, tape and steroid injection - surgical revision plus post-op adjunct.

  • Not right for: active keloid, first year of a burn scar

    Active keloids are made worse by unsupported excision. Burn scars keep remodelling for 12–18 months - most should not be revised until then.

Procedure options

Every scar has a technique - Z-plasty, W-plasty, GBLC or release.

The technique choice depends on scar direction, length, tension and location. A single surgeon will use several across a career, matching tool to scar.

  • Simple re-excision with layered closure

    For a stable, widened but well-oriented scar - excise and close in layers, offload tension with deep dermal sutures. Fine, narrower result at 12 months.

  • Z-plasty

    Two triangular flaps swapped to rotate the scar axis onto a relaxed skin-tension line. Lengthens the scar in one direction and shortens it in the other - the go-to for facial and joint scars.

  • W-plasty

    A running-W closure that breaks a long linear scar into small zigzags the eye no longer follows. Useful in cheek and forehead scars parallel to lines of expression.

  • Geometric broken-line closure (GBLC)

    An irregular closure combining triangles, rectangles and semicircles - camouflages long straight scars where a running W would still be recognisable.

  • Contracture release with skin graft

    Release the contracted band, cover the defect with a full-thickness skin graft. Post-op splinting is essential to hold the release.

  • Contracture release with local flap

    For deeper contractures or those crossing joints - a local rotation, transposition or perforator flap provides supple like-for-like tissue.

  • Hair transplantation into scar

    Follicular-unit extraction (FUE) grafts placed into a hairline, brow or beard scar 6–12 months after healing. Two sessions usually needed.

  • Dermabrasion at revision

    Mechanical resurfacing at 6–8 weeks after revision blends the new scar edges into surrounding skin. Not the same as pure resurfacing.

Safety and recovery

What to expect afterwards - honestly.

Scar revision is well established. The important conversation is timing, technique choice and the adjuncts that follow.

  • Small procedure, local anaesthetic for most

    Most revisions are 30–75 minutes under local anaesthetic in a treatment room. Larger revisions, releases and grafts need sedation or GA.

  • The new scar takes 12 months to mature

    It looks red and raised at 6 weeks, softens by 3 months, matures over 12 months. Judgment on the final result is at one year, not two months.

  • Silicone, tape and sun protection are non-negotiable

    Silicone gel or tape for 12 weeks, and daily SPF50 for 12 months, halve the risk of a poor result. Compliance matters as much as the surgery.

  • Post-inflammatory hyperpigmentation

    Higher risk in Fitzpatrick IV–VI skin - mitigated with strict sun protection, tyrosinase-inhibitor skincare pre- and post-op, and gentle laser only after 6 months.

  • Recurrence, especially in hypertrophic scars

    Around 10–20 percent of hypertrophic scar revisions recur without post-op adjuncts. Silicone, steroid injection and low-energy vascular laser at 6–8 weeks reduce it substantially.

  • Keloid - a specialist conversation

    True keloids often respond poorly to plain excision. If a keloid diagnosis is confirmed, we plan excision with immediate low-dose radiotherapy or intralesional 5-FU/steroid rather than unsupported surgery.

  • Wound infection, dehiscence, seroma

    Under 2 percent in clean, elective surgery. Call same-day for spreading redness, discharge, fever or wound separation.

  • Nerve injury near facial or joint scars

    Discussed pre-op for scars near the facial nerve, digital nerves or supra-orbital region. Meticulous consultant-level technique keeps rates very low.

  • Red flags after revision

    Sudden bleeding through dressings, spreading redness, fever, or a rapidly hardening lump under the scar need same-day team review, not a routine call.

Reading your notes

Your notes in four parts. Read the last one first.

Whether Z-plasty, W-plasty, contracture release or hair transplantation into scar, the operation note keeps to the same shape.

A UK consultant plastic surgeon reviewing scar revision notes

A quiet reminder

Clinical language is precise and can read coldly - ask your care team to explain anything that is unclear.

Ask your care team to explain anything that is unclear.

  1. 01 Header

    Site, technique and closure

    Where the scar is, which revision technique was used (excision, Z-plasty, W-plasty, GBLC, contracture release), and how it was closed.

  2. 02 Technique

    Anaesthesia and undermining

    Local, sedation or GA; how much subcutaneous undermining; whether a graft or flap was used; suture materials.

  3. 03 Findings

    Skin condition and any histology

    Skin quality, whether tissue was sent for histology (rare, for scars with atypical features), and any intra-operative surprises.

  4. 04 Impression

    Aftercare plan, silicone, laser follow-up

    Read this first: suture removal date, silicone start date, sun protection, and 6-week laser or steroid injection follow-up if applicable.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Scar revision surgery is covered where a scar restricts function (contracture) or was caused by an insured event. Purely cosmetic revision is self-pay.

Frequently asked

Everything we get asked about scar revision surgery.

Quick answers on timing, technique, cost and realistic outcomes.

  • When is the right time to revise a scar surgically?

    For most scars, wait until 12 months from injury or surgery, when the scar has fully matured - it is softer, paler and its final shape is visible. Revising a scar at 3 months usually just gives you a bigger, redder scar. The exceptions are true contractures limiting movement, mis-aligned facial borders, and heavily trapdoored scars - all of which can be revised earlier if judgment favours it.

  • What is the difference between scar revision surgery and scar treatment?

    Scar revision surgery cuts, moves, releases or re-closes the scar itself - physically changing its shape, direction or tension. Scar treatment is non-surgical modalities on an intact scar - silicone, steroid, laser, cryotherapy, microneedling. Most scars respond to non-surgical treatment first; only some need revision, and many need both, in sequence.

  • What is a Z-plasty and when is it used?

    A Z-plasty is a small operation that takes a straight scar, cuts two triangular flaps either side of it, and swaps them - rotating the scar axis by 60 degrees and lengthening it. It changes the direction of a mis-aligned scar onto a natural line of the face or breaks up a contracted band across a joint. It works because a rotated scar catches the eye less than a straight one, and a lengthened scar releases tension.

  • How much does private scar revision cost in the UK?

    Roughly £850–£1,800 for a small re-excision, £1,600–£3,500 for a facial Z-plasty or W-plasty, £2,800–£5,500 for larger revisions, £4,500–£9,000 for contracture release with skin graft, and £5,500–£11,000 with a local flap. Hair transplantation into scar tissue is £3,500–£8,500. Consultation is £250–£400.

  • How long is recovery after revision?

    Sutures out at 5–7 days on the face, 10–14 days on the body. Back to office work in 1–5 days. Exercise avoided for 4 weeks to reduce widening. No sun on the scar for 12 months. Silicone gel or tape for 3 months. The final look is judged at 12 months, not 6 weeks.

  • Will scar revision leave no scar at all?

    No - every skin incision leaves a scar. The realistic goal is a better scar: narrower, flatter, paler, better aligned to natural creases, or (for contractures) one that no longer restricts movement. Complete invisibility is not achievable in adult skin, and any surgeon who promises it should not be trusted.

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