Integrating Microneedling with Surgical Techniques for Improved Postoperative Scar Aesthetics
Abstract
Background: Postoperative scar formation remains an important determinant of cosmetic and patient-centered surgical outcomes. Objective: To evaluate the effectiveness of integrating microneedling with surgical scar management for improving postoperative scar aesthetics compared with conventional scar management alone. Methods: This comparative cross-sectional analytical study was conducted at Khyber Girls Medical College from January 2025 to January 2026 including 196 patients with postoperative linear surgical scars. Patients were allocated into conventional scar management and surgery plus microneedling groups. Results: Baseline characteristics were comparable between groups. The microneedling group demonstrated significantly better scar outcomes, with lower Vancouver Scar Scale scores (4.9 ± 1.7 vs. 8.4 ± 2.1; p<0.001), improved POSAS observer scores (18.3 ± 5.2 vs. 29.6 ± 6.8; p<0.001), and better patient-reported POSAS scores (19.7 ± 5.9 vs. 31.4 ± 7.3; p<0.001). Scar thickness was significantly lower (2.1 ± 0.8 vs. 3.8 ± 1.1 mm), while pigmentation irregularity and poor pliability were less frequent. High patient satisfaction was significantly greater in the microneedling group (84.7% vs. 50.0%). Conventional scar management alone was the strongest predictor of poor scar outcome (aOR 4.28; p<0.001). Conclusion: Integration of microneedling with surgical scar management significantly improves postoperative scar aesthetics, symptom burden, and patient satisfaction compared with conventional scar care alone.