From June 5 to 7, 2026, the 2nd China Scar Treatment Technology Progress Conference was held in Shanghai. Professor Xie Weiguo, Chief Expert of Bakang Medical, chaired the first thematic forum of the conference and delivered a special report titled "Advances in Scar Volume Reduction Surgery," which was well-received and highly praised by the attendees.

Hypertrophic scars and keloids are the most challenging types of scars to treat. These scars not only have a stubborn pathological formation mechanism but are also particularly thick, making common clinical treatments such as topical medications, scar injections, silicone products, pressure therapy, and phototherapy limited in efficacy, slow to take effect, and often requiring long treatment periods, leading to poor patient compliance.

Scar volume reduction surgery refers to methods that can reduce scar volume in a single session, including fiber laser ablation, scar core excision, punch excision, and cryosurgery. These methods can quickly reduce scar volume and thickness, making them popular among patients.

Professor Xie's team conducted a clinical study on fiber laser scar ablation involving 147 patients. The results showed significant improvements in scar thickness, hardness, redness, and pain and itching symptoms. Patients of different ages, body parts, and initial treatment times all showed good outcomes. The main side effect was necrosis and ulceration of the scar due to high heat, with an overall incidence of 6.7%.

Professor Xie Weiguo's extensive clinical cases demonstrated the implementation and excellent efficacy of this innovative technology. For example, a 13-year-old girl with a burn scar on her jaw underwent a single fiber laser treatment, and after two months, the scar thickness decreased from 1.13 cm to 0.72 cm, and the hardness index decreased from 61.4 to 57.3. The modified Vancouver Scar Scale and pain and itching symptoms also showed significant improvement.

In 2021, renowned scholar Ogawa used punch excision for the treatment of hypertrophic scars.

Using a 0.6–4.0 mm punch to vertically excise hyperplastic collagen fiber masses within the scar can directly reduce the scar volume. Dense punctures disrupt the disordered collagen framework within the scar, interrupting the microenvironment for continuous fibroblast proliferation and reducing the tension of contractile scars. In recent years, punch excision has been increasingly reported for the treatment of hypertrophic scars and keloids. Professor Xie not only presented his clinical practice cases but also introduced new ideas and methods for improving punch excision both domestically and internationally.

Scar core excision has a long history. French military doctor Druit first reported using core excision for keloid treatment in 1844. By surgically removing the dense fibrous core of the scar and suturing the lateral scar flap in place, it formed the prototype of modern scar core excision. In the 20th century, many clinical reports on the use of scar core excision for scar treatment were published in Chinese and foreign medical journals. Professor Xie began to use scar core excision for the treatment of hypertrophic scars this year, achieving good results.

A typical case presented was a 6-year-old boy with a facial burn scar that was over 15 mm thick at its thickest point. After undergoing core excision followed by CO₂ fractional laser treatment, the scar thickness was reduced to nearly normal skin, with a significant improvement in appearance.

Cryosurgery for scars was first reported in 1982, initially used for small keloids such as earlobe keloids, with methods including liquid nitrogen spray, contact cryosurgery, and intra-scar cryosurgery. The drawbacks of this method include postoperative blistering, necrosis, infection, pigmentation, and hypopigmentation, as well as a relatively long healing period. In recent years, foreign scholars have developed specialized equipment for intra-scar cryosurgery, improving the simplicity and safety of the procedure.

Topical liquid nitrogen cryosurgery

Intra-scar cryosurgery

President Xie Weiguo pointed out that existing scar volume reduction surgeries, when used alone, still have uncertainties in efficacy, side effects, and the risk of postoperative scar recurrence. Combining these methods with laser, corticosteroids, and radiotherapy is an important research direction to improve efficacy and reduce postoperative scar recurrence.