Operation or not on a hypertrophi scar?

This is the scar of my 2 years old son. Last year in November he got burned. No skin graft was performed on him. We are treating him with silicone creams, silicone sheets and pressure garments but still the scars look bad. My question is what would be the best treatment to go on with... silicone and pressure garments or surgery?



F, Romania

You should seek the opinion of a board certified plastic surgeon in your area. This scar will not go away with silicone cream. 

He will likely need a surgical procedure to improve the appearance of the scar.  If the skin around it is lax, it may be able to be excised and closed.  If not, he would either need a procedure where a tissue expander is first inserted under the nearby skin in the first stage then an excision in the second stage, or else serial excisions could be performed.  Serial excisions involved removing as much of the scar as can be removed, and then coming back a few months later to remove more of the scar.  This is done until the thick scar tissue is removed.  I recommend you consult with a qualified plastic surgeon in your area to discuss the options.  Good luck.