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Published online by Cambridge University Press: 02 November 2023
Visible scars in the face are an important clinical entity, especially in the wake of trauma and cancer surgery. The first phase of wound healing is the inflammatory phase; the second phase of wound healing, the proliferative phase, is characterized by epithelial regeneration and collagen synthesis.
Tension is the overriding factor adversely affecting all phases of wound healing. Repetitive tension leads to inflammation, which in turn causes increased collagen synthesis and deposition of glycosaminoglycans, resulting in prolonged erythema and scar hypertrophy.
Underlying musculature can generate dynamic tension on a healing wound, particularly in the face.
A reduction of secondary tension and movement of the healing scar was achieved with injection of botulinum toxin into the musculature subjacent to the scar. As a result, repetitive movement of the wound edges was minimized, unfavorable effects of repetitive microtrauma on wound healing reduced and healing improved.
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