Abstract
A request for scar revision or correction of a cutaneous defect is common. Some patients request surgery for a cutaneous disease when, in fact, medical treatment is appropriate. Most patients when so informed accept proper treatment. However, some persist in their desire for surgery and are convinced that this is the only effective treatment. Nonhealing cutaneous processes or diseases and unstable, hypertrophic, contracted, or depressed scars are problems for which surgical correction may be appropriate. Surgical correction in patients with unrealistic or illusory expectations should be avoided. Patients with self-induced disease may benefit from a psychotherapeutic program ifthey are compliant with this mode of treatment. 1 However, improper motivations and lack of insight can complicate diagnosis and therapy. We discuss two patients in whom surgical scar revision would be inappropriate.
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