http://www.scarlesstheclinic.com.au/

Scarless - The Clinic, East Sydney Private Hospital, Suite 1, Level 6, 75 Crown Street, Sydney (2026)

29/01/2026

Fractional ablative lasers (AFL), such as the CO2 or Erbium cold fibre, does more than just resurface scars — it fundamentally changes how tension affects scar tissue through two distinct mechanisms.

First, the laser vaporises hundreds of small tissue columns throughout the scar, creating an immediate mechanical release of tension.

Many patients notice this effect straight away after treatment.

The scar simply feels different, less tight and constricted.

This early change is often temporary, as some swelling and tissue remodelling occur in the days that follow.

Second, these micro injuries trigger a remodelling process that changes the type of collagen in the scar tissue, resulting in an overall decrease in tension as healing progresses.

This isn't just surface treatment—it's restructuring the scar from within.

Research shows AFL-CO2 can decrease excessive blood vessel formation in immature scars whilst increasing blood supply in mature scars that have become poorly perfused.

This dual effect on vascularisation, combined with improvements in pliability and thickness, enhances overall scar quality.

These changes in the scar tissue create optimal conditions for subsequent treatments or surgery.

Better-perfused, more pliable tissue with reduced tension supports improved wound healing, better surgical outcomes, and reduced complications in the surgical field.

Whilst surgery remains very effective for restoring range of motion, ablative fractional resurfacing addresses other crucial aspects of hypertrophic burn scars including symptoms, thickness, function, and quality of life—often serving as valuable preparation before surgical intervention or as treatment in its own right.

28/01/2026

Before and 8 weeks after 2x multimodal laser scar revision procedures of tethered post surgical scar.

*Comments are turned off in line with AHPRA advertising guidelines.

*All medical procedures carry inherent risks and potential complications. A thorough consultation and clinical assessment are required to determine suitability for treatment. Individual outcomes may vary.

27/01/2026

Skin grafting is a surgical procedure that involves transplanting healthy skin from one area of the body to another.

Understanding when and how this procedure is used can help demystify an important reconstructive technique. In reconstructive surgery, skin grafting sits on an early step of the ‘reconstructive ladder’—used when simple closure isn’t possible but more complex flap procedures aren’t yet required.

When skin grafts are used:

Skin grafts are typically considered when wounds are too large to heal on their own or when direct closure isn't possible.

Common situations include severe burns, extensive wounds from trauma or surgery, chronic ulcers that haven't responded to other treatments, and reconstructive procedures following skin cancer removal.

There are two main types of skin grafts: split-thickness skin grafts (STSGs) and full-thickness skin grafts (FTSGs).
STSGs include the epidermis and part of the dermis and are generally used for larger wounds, as they reliably take and heal more quickly.

FTSGs include the entire dermis and are used for smaller, more visible areas where better colour match, texture, and durability are important.

The most suitable option will be based on the wound’s requirements and expected functional and aesthetic outcomes.

Call us to book a scar assessment and consultation: +61 2 9037 6306

26/01/2026

Not all problematic scars are the same, and understanding the role of tension in scar formation is crucial for determining the right treatment approach.

Wound contraction creates tension, and when combined with individual factors like genetics, skin type, and healing response, this tension can lead to thick, raised, red scars that become itchy and painful.

These hypertrophic scars result from excessive collagen production driven by mechanical forces on healing tissue.
However, the opposite scenario can also occur.

When there's too much tension placed on a wound, whether from the surgical closure itself or from the wound's location on the body, combined with certain individual factors, scars can become thin, widened, and typically discoloured. These stretched scars represent a different type of healing problem altogether.

This is why abnormal scars represent a loss of the control mechanisms that normally regulate the delicate balance between tissue repair and regeneration. The body's healing response has veered too far in one direction or the other.

Proper scar assessment is vital to determine which scenario you're dealing with. A thick, raised scar requires different interventions than a thin, widened one. Treatment approaches that help one type of scar might be inappropriate or even counterproductive for the other.

This is where specialist expertise becomes essential. A thorough evaluation considers not just how the scar looks, but the mechanical forces involved, your individual risk factors, and the specific characteristics that indicate whether tension has driven excessive tissue formation or inadequate structural support.

If you're concerned about a scar—whether it's thick and raised or thin and widened—our specialised team can provide a comprehensive assessment to determine the most appropriate treatment approach for your specific situation.

Book a consultation to discuss your scar and develop a personalised treatment plan.

22/01/2026

Lymphorrhea—often called "leaky legs"—is one of the most challenging complications of lymphoedema care, yet it's frequently under-recognised and inconsistently managed.

When lymphatic fluid seeps through the skin, it creates persistent wetness that affects skin integrity, increases infection risk, and significantly impacts patients' comfort, mobility, and quality of life.

For those experiencing this condition, even simple daily activities can become overwhelming.

Effective management of lymphorrhea requires a comprehensive approach.

Using compression therapeutically, protecting skin from maceration, choosing appropriate dressings that work under compression, and providing practical day-to-day support all play crucial roles in improving outcomes.

Adjunctive modalities may also be employed to optimise local tissue conditions — such as the judicious use of energy-based treatments and photobiomodulation — to support epithelial recovery and modulate the inflammatory environment.

With coordinated, patient-centred care, significant improvements are possible even in challenging cases.

The right combination of clinical expertise, appropriate treatment strategies, and genuine partnership between healthcare providers and patients can transform quality of life for those living with this condition.

21/01/2026

Tethered scars can create a “pulled-in” or dimpled appearance when they adhere to deeper tissues beneath the skin.

This can occasionally occur at sites where surgical drains have been placed — as the drain tract may heal with a dense adhesion anchoring the scar down.

This scar was released in a short in-clinic procedure under local anaesthetic, allowing the surface contour to flatten and tension to reduce.

*All procedures carry risks, and individual responses to treatment can vary. While we use evidence-based techniques (where available) to significantly improve the appearance and texture of scars, it is important to understand that some degree of scarring will always remain, and complete scar removal is not possible.

Book a consultation or call us at +61 2 9037 6306

20/01/2026

Feeling prepared can make all the difference when approaching scar treatment.

Knowing what to expect and how to prepare helps you feel confident and ready. Swipe through for essential preparation tips that will help you on treatment day and beyond.

18/01/2026

Your immune system doesn't just fight off infections—it plays a central role in determining how your wounds heal and whether scars form.

Understanding this relationship is crucial for effective scar treatment, particularly when immune disorders are involved.

During normal healing, immune cells like macrophages coordinate repair by first promoting inflammation to clear debris, then shifting to an anti-inflammatory state that supports tissue remodelling.

When this carefully timed sequence becomes dysregulated, scarring problems emerge.

Research shows that excessive immune cell activity and overproduction of inflammatory cytokines drive problematic scar formation, including keloids and hypertrophic scars.

Prolonged inflammation is a key factor in pathological scarring, which is why early interventions targeting excessive inflammation have shown benefits in minimising scar formation.

When someone has an immune disorder, scar treatment becomes more complex.

Autoimmune conditions, immunosuppressive medications, and altered immune responses all influence how wounds heal and how scars respond to treatment.

Systemic inflammation can increase the risk of abnormal scarring, making it essential to account for underlying immune status when planning treatment.

For patients with immune disorders, scar treatment must be personalised to their altered immune context.

This might mean adjusting treatment timing, modifying approaches to avoid triggering unwanted responses, or coordinating with specialists managing the underlying condition.

The relationship between immunity and scarring reminds us that effective scar management requires understanding each patient's unique biological context, including how their immune system functions.

15/01/2026

At our clinic, we use both the CO₂ UltraPulse® Alpha laser and the UltraClear™ cold fiber laser, which allow us to tailor treatment intensity and depth to each scar type.

This approach is effective for various types of scars, particularly hypertrophic and burn scars, and forms an important part of many personalised scar treatment plans.

13/01/2026

This post–hip replacement scar was treated in a single in-clinic session under local anaesthetic, using a multimodal approach that combined targeted release with evidence-based scar therapies to improve contour and reduce mechanical pull during activity.

Book a consultation or call us at +61 2 9037 6306

*All procedures carry risks, and individual responses to treatment can vary. While we use evidence-based techniques (where available) to significantly improve the appearance and texture of scars, it is important to understand that some degree of scarring will always remain, and complete scar removal is not possible.

12/01/2026

Understanding why some scars become thick and contracted requires looking at the mechanical forces at work during healing.

It's not just biology — it's biomechanics. During normal wound healing, myofibroblasts are the cells responsible for wound closure.

Their job is to contract and pull the wound edges together. In optimal healing, these cells complete their work and then disappear through natural cell retirement.

However, when myofibroblasts persist beyond the healing phase, problems arise leading to fibrosis, tissue contractures, and hypertrophic scars.

What keeps these cells active when they should be retiring?

A complex feedback loop involving mechanical stress, growth factors, and cellular signalling pathways.

Fibroblasts are highly responsive to mechanical forces, which is why wounds in areas under high tension and constant stretching (like the chest, shoulders, or across joints) are more prone to developing problematic scars.

Mechanical forces don't just influence these cells passively. Tension actively upregulates genes that produce more scar tissue whilst simultaneously preventing the normal cell disappearance that should limit scar formation.

This creates a "double burden": more cells producing more matrix, all kept active by ongoing mechanical stress. The result is thick, contracted scars in high-tension areas.

This understanding has important implications for treatment.

Reducing tension in tissues surrounding a wound may have significant therapeutic effects on the myofibroblasts within scars themselves, helping prevent excessive scar formation before it becomes established.

08/01/2026

Progress update following two sessions of comprehensive multimodal scar revision therapy for a hypertrophic, contracted scar with limited functional extension of the elbow.

This developed after wide excision of a melanoma on the elbow and coverage of the defect with a skin graft (donor site: thigh), which was also erythematous and mildly hypertrophic.

At 6 weeks after the second treatment, there is a measurable improvement in elbow extension (1 cm), with enhanced scar pliability, improved vascularisation and reduced thickness at the graft site.

The donor site also shows improved colour, texture, and thickness. Treatment is ongoing.

*All medical procedures carry inherent risks and potential complications. A thorough consultation and clinical assessment are required to determine suitability for treatment. Individual outcomes may vary.

Scarless - The Clinic

29/01/2026

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