Awake face surgery
Awake Scar Revision in Ottawa
Scar revision aims to improve the look of a scar by repositioning, narrowing or reshaping it. It is typically performed under local anesthesia, so awake surgery is a natural fit.
Scar Revision at a glance
| Typical operating time | About 30 to 90 minutes |
|---|---|
| Awake suitability | Often a good candidate for awake surgery |
| Typical return to desk work | Back to normal activity in days |
| Anesthesia | Local anesthesia with or without sedation. General anesthesia arranged if needed |
| Setting | Outpatient, with an anesthesiologist present throughout |
Times are typical ranges for planning, not promises. Your plan is individualized.
What is scar revision?
The scar is removed or reshaped and closed with careful technique. Some scars are treated with other approaches such as injections or lasers. Scars cannot be erased.
Who may be a good candidate
- People with wide, raised or poorly positioned scars
- Those whose scars have matured, usually after 6 to 12 months
Why awake scar revision may work
Revisions of small to moderate scars can be done with local anesthesia, with sedation if desired. Reviews of tumescent anesthesia in dermatologic surgery describe extending local anesthesia to a range of skin procedures.
When awake may not be the right choice
Large or complex revisions may call for deeper sedation or general anesthesia.
Your awake scar revision journey
1. Before surgery (pre-op)
We assess the scar, its direction and tension, and discuss realistic goals.
- A consultation to review your goals, health history, medications and previous surgeries, and a physical examination
- An anesthesia assessment to decide whether an awake plan is appropriate and safe for you
- Photographs, with your consent, and a written plan, quote and consent form
- Medication guidance, including when to stop blood thinners, certain supplements, and smoking or vaping
- Fasting instructions from the anesthesia team. Follow them exactly
- A ride home and an adult to stay with you after surgery
2. Day of surgery (intra-op)
The scar is numbed and revised, and closed in layers.
- You arrive, change, and meet the surgeon and anesthesiologist, and your markings and plan are confirmed
- An IV and monitors are placed. The anesthesiologist stays with you from start to finish
- Local anesthetic is given. Expect brief stinging, then numbness, and light sedation if planned
- You can listen to music, talk with the team, and tell us at any time if you feel discomfort
- Afterward you rest in recovery, receive written instructions and go home with your driver
3. Recovery (post-op)
You are observed in recovery, given written instructions and pain-control guidance, and scheduled for follow-up. Call us or seek urgent care for fever, spreading redness, severe or worsening pain, heavy bleeding, chest pain, shortness of breath, or leg pain or swelling.
| When | What is typical |
|---|---|
| Days 1 to 3 | Mild soreness and swelling. |
| Weeks 1 to 2 | Sutures removed. |
| Weeks 4 to 12 | New scar is pink and firm. |
| 6 to 12 months | Scar matures. |
Timelines are general and vary. Your surgeon gives you instructions specific to you.
Anesthesia options
Anesthesia options range from local anesthesia, with or without sedation, to general anesthesia. An anesthesiologist is present throughout your procedure and recommends an approach after reviewing your health, the extent of surgery and your preferences. If an awake approach is not suitable, general anesthesia is arranged. Plans can change during surgery if comfort or safety requires it, including deepening sedation or converting to general anesthesia.
Learn more: anesthesia options, levels of anesthesia, fear of intubation, and pain perception and music.
Alternatives
Silicone sheeting, injections, laser, or observation.
Risks
Recurrence of a wide or raised scar, infection, bleeding, asymmetry, and altered sensation.
Anesthetic risks include reactions to medications, breathing or airway events, the need to deepen sedation or convert to general anesthesia, and, rarely, transfer for further care. All surgery carries risk, and results are not guaranteed.
Frequently asked questions about awake scar revision
Will the scar disappear?
No. It can usually be improved but not erased.
Can it be done awake?
Often yes.
When is the best time?
Usually after the scar has matured.
Could it get worse?
Some people form keloid or raised scars, which we discuss.
Related procedures
Starting from $800 (CAD, before 13% HST), including surgeon, anesthesia and facility fees. Your written quote follows your consultation. See pricing and financing.
Explore your options at a consultation
References
- Uttamani RR, Venkataram A, Venkataram J, Mysore V. Tumescent anesthesia for dermatosurgical procedures other than liposuction. J Cutan Aesthet Surg. 2020;13(4):275-282. PMID 33911407