I have a couple of noticable scars on my face. I want to know what is the MOST effective (with long-term results) way to reduce them. I'm looking into scar revision and Fraxel laser treatment. I have discoloration and the scars not keoloid, their from a dog bite and indent inward slightly. I really want the best results and am extemely nervous, please help!!!!
Best Method for Dog Bite Scar Removal?
Doctor Answers 11
No Easy Answer
There's no easy answer to your question. Scars are permanent and treatments that exist serve only to improve - not remove - them.
There are likely two different concerns you may have.
The first is contour irregularities that may exist. Dog bites can destroy underlying tissue including even bone. Most bites involve some destruction of the subcutaneous fat. Improvement of this can be achieved with deep scar release and fat grafting. This can substantially improve contour abnormalities.
You scar is also likely hyper or hypo pigmented and the dermis of the scar itself may be thicker or thinner than the surrounding skin. These issues are harder to treat. Peels, dermabrasion and laser can all be effective tools to make small improvments.
I hope this helps.
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Scar revision for dog bite
It's very difficult to say without seeing your scar, but there are several options.
- Surgical Revision
- Laser Treatments (CO2, Erbium, Fractionated)
There may not be one "best" treatment, but rather several options all with pros and cons. We suggest getting several consultations with different kinds of specialists, plastic surgeon, facial plastic and dermatologist before making a decision. Good luck.
Dog Bite Scar on the Face
A dog bite scar may be discolored, thickened, or depressed and may require multimodality treatment including scar revision, topical silicone, and topical creams for skin lightening. Silicone sheeting alone plays a minimal role in this problem.
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An exam would help determine this
Dog bites can be complicated with deep punctures and some tissue shredding dependent upon the type of dog. Some of these are best treated with scar revision plus or minus tissue expansion. Often this can be kept simple and less expensive. You really need a good evaluation to help figure this out though.
Surgical revision and Fraxel may help with the scars
Sometimes Fraxel can provide enough of an improvement but surgical scar revision prior to Fraxel or other resurfacing treatments may be needed to make the linear indent more flush with the surrounding skin. It’s not a bad idea, if the doctor can do this, to revise one small part of the scar so you and the physician can see how your healing properties allow the skin to look. After this type of treatment, improvement occurs over several months so don’t give up, be patient and good luck.
I recommend Plastic surgery consultation for surgical revision
There are a few things to consider regarding scar revision.
How long from the injury? Usually it is best to wait about a year before a revision is performed.
How does the scar look? Should it be revised at all, or should it be left alone. Will a revision have a better chance of looking better than the scar?
One thing that you mentioned was that the surface is irregular, an indentation. To me, this indicates that is likely loss of deeper layers of the skin (dermis), resulting in depression of the surface. This to me further indicates that a surgical correction is in order.
There are a large number of surgical techniques to correct the scar. The one chosen will depend on the scar, the location of the scar, and the direction of the scar vs. natural wrinkles (best scars lie in a wrinkle, and the worst tend to be perpendicular to them).
Despite the specific technique, the procedure should not be bad, as it should be able to be performed under local anesthesia.
Treatment for dog-bite scars
The resurfacing lasers might be a good option for your scars.
The best treatment really depends on the shape and depth of your scars. If the scars are spoon-shaped or box-car depressed scars, you would benefit from a procedure called saline subcision. The depressions can also be elevated to the level of the skin surface with fillers, for example Restylane or Radiesse. For deep tapering ice-pick type scars, one option is to punch excise these scars, followed by laser resurfacing.
I encourage you to seek consult with a board certified practitioner (dermatologist or plastic surgeon) experienced in treating scars.
We really need to see pictures to give specific advice
Jaboe, We really need to see your pictures to give specific advice. Not all scars are the same. Some are helped by laser, some by steroid injections, some by dermal fillers or fat grafting, some by excision, etc.
Dog Bite Scar on Face Treatment With Fraxel
Both Fraxel re:store and re:pair effectively treat facial scars very well. There are many other lasers and other methods to treat scars from dog bites on the face, but I have found that Fraxel is among the best. In Las Vegas, Robert Troell, MD would be a good facial plastic surgeon source to consult with.
Good luck and be well.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.