I'm a 29-year-old African American woman. I had VASER Liposelection and Laser Lipo in November, and I now have keloid scars and dark spots. What can my doctor and I do to correct these?
Dark Spots and Keloid Scars After VASER Liposelection and Laser Liposuction
Doctor Answers 8
Keloid scars and hyperpigmentation
True keloid scars can be treated by a number of different procedures, including application of silicone, pressure, and injection of TAC. Hyperpigmentation can be improved with judicious use of cortisone based creams, topical retinoids, and prescription skin lighteners.
I would recommend the Melarase AM cream for hyperpigmentation.
Aggressive approach is best for keloid scars
In my experience treating patients with your skin type for problem scars, taking an aggressive approach right off the bat is most likely to result in patient and doctor satisfaction.
This would involve excision of the problem scar, repair using an alternative technique to that initially used, and topical treatment with silicone tape, Scarguard, or some other similar option.
This almost always gives a significantly improved outcome, although it does require the excision.
Dark spots after VASER
The dark spots, I assume, are at the port sites of the VASER. The darkness can stay for a while, sometimes as long as a year or more. If your scar is truly keloidal, then there are multiple modalities for treatment that can vary using re-excision, steroids, and a combination of the two among many other options. If they are just hypertrophic, they sometimes can be treated as I mentioned for keloids, but you can add compression and silicone sheeting.
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You need compression, steroids, time
Seems like hypertrophic scars. I would start with compression and intralesional injection of dilute steroids. There are more agressive treatments but this will be a good start.
Make sure you mention this in the future before any surgery.
There may be hope for Keloid and Dark Spots
Given the dark pigmentation of your skin, yes, you are already at higher risk for such issues. The keloids, I would assume, are from the incision scars. What can be done is several things.
I have used silicone sheets over such scars, and I have injected the scars with steroids, in particular Kenalog. Scar massage by yourself may also help as well.
As far as dark pigmented areas, hydroquinone may help, which is a bleaching cream in essence. You have to be careful in your case to not get hypopigmented areas.
I feel that a combination of the above options is needed to help with keloids, as they are problematic.
Hope that helps.
Dark spots and ugly scars after VASER Liposelection and Laser Liposuction
Unfortunately, in many darker pigmented people even minor trauma results in darker scars. (Look at the forearms of women - you will frequently find short lines from either cooking oil splatter or scratches). This means that EVERY cut, regardless of the mechanism, may in such predisposed people result in darker spots / linear scars.
It does NOT help if such skin is exposed to friction / heat or the Liposuction openings are NOT stitched properly or left open to heal by themselves. As a precaution the skin adjacent to the liposuction openings is best removed with a scalpel at the end of the operation and put together meticulously to get the best possible scar.
In your case, I would advise you to see your (hopefully) Plastic surgeon and have him / her revise your scars. You can choose to do the worst one as a "test run" and see how it heals before doing all of them.
Dr. P. Aldea
Steroids may help
The keloids may be from the incision or the heat generated from vaser. A keloid is a raised thickened scar that is actually larger than the original cut.
Steroid injections may help it settle down and soften. Time may also help. The down side to the steroids is that they can thin the skin, and cause loss of pigmentation. Other ideas may include silicone sheeting, compression garments, massage.
Keloid versus Hypertrophic scars
There is a big difference bewtween Keloid and Hypertrophic scars
- Hypertrophic = large thick scars
- Keloid = grow beyond dimensions of initial injury
It is most likely you have a hypertrophic scar. This may stay thick for up to two years before softening.
General non-surgical scar therapy includes:
- Time for scars to resolve (up to two years)
- Pressure treatment
- Topical silicone gel sheeting or silicone preparations (many options available)
- Avoidance of sun exposure
- Intralesional steroids
- Radiation therapy for severe keloids unresponsive to conventional therapy
- Off-label use (anectodal reports) of intralesional 5 FU (chemotherapy)