Widening of scars: Foe coaxed into a friend? The Millard technique revisited

Widening of scars is a frustrating event that most if not all plastic surge ons have encountered. Several therapeutic modalities have been proposed, bu t frequently the result is disappointing. During revision surgery, it is ad vocated that the dermal scar be used in providing support to the tissues in stead of being discarded. The author proposes a technique by which tension on the wound is carried by tough scar tissue instead of the suture line, th ereby reducing the incidence of postoperative widening. This technique was used to treat 35 nonburn scars that had widened: 31 scars were facial (24 p atients) and 4 were inframammary (2 male patients). All scars were at least 4 months old. The operations were performed between February of 1996 and D ecember of 1998; follow-up was 9 to 14 months. Only one scar widened during the follow-up period. Overall, 71 percent of patients rated the improvemen t as marked. This is a revisiting of the original Millard's technique, whic h seems to have fallen into oblivion. The author recommends this technique in dealing with widened scars during revision surgery.