Fig. 28

Surgical excision and closure with simple sutures. When excising keloids or hypertrophic scars from body sites that have strong skin tension (e.g., the trunk), the fatty tissues should be removed along with the scar. The fasciae should then be undermined. Thereafter, the fasciae should be sutured so that the upper layers of the skin approximate each other closely. This makes it easy to place dermal sutures with minimal tension