How can I address these sagging scars on my butt from a BBL? (photo)

Question

Good evening. I had a BBL in 2018 and I had my scar sites treated with kenalog a few times and it created divots on both sides that bothered me. I had Scar removal surgery August 2023 now the scars appear lax and are again messing up my side profile. I have tried 3 radio frequency microneedling sessions and it didn't help (left me with grid marks, no tightening). What are non surgical options to fix this? Saline injections were suggested by an NP. I am afraid I'll feel under my skin

Anna Chacon, MD, FAAD · Answer

Addressing sagging scars after a BBL can be challenging, but there are several non-surgical options you might consider:

Saline Injections: As suggested by your nurse practitioner, saline injections can help by temporarily filling the divots and improving the appearance of the scars. While you may have concerns about feeling the solution under your skin, this sensation is usually minimal and temporary.

Dermal Fillers: Hyaluronic acid fillers can be used to fill in the divots and provide a smoother contour. These are generally well-tolerated and results can last several months, offering a temporary but effective solution.

Laser Therapy: Fractional laser treatments can help improve skin texture and stimulate collagen production, which may aid in tightening the skin and improving the appearance of scars over time.

Platelet-Rich Plasma (PRP) Therapy: PRP can promote skin healing and collagen production, potentially improving the texture and appearance of scars.

Topical Treatments: Silicone gel sheets or creams can help in flattening and softening scars over time. While they may not address sagging directly, they can improve overall scar appearance.

Consultation with a Specialist: It's important to consult with a board-certified dermatologist or plastic surgeon who specializes in scar revision to tailor a treatment plan to your specific needs and concerns.

Each option has its pros and cons, so discussing these with a specialist will help you decide the best course of action based on your goals and skin type.

Raffy Karamanoukian, MD, FACS · Answer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser.  Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.  
Best,
Dr. Karamanoukian 
Realself100 Surgeon

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