Lip lift scar treatment - will laser resurfacing help?

Question

Hello I am interested in scar removal procedures. 11 months ago I had lip lift surgery and was left with a terrible scar under my nose. I had steroid injections for a raised scar, the scar is deep on one side. Will laser scar resurfacing help me and what can be done with a deep scar? Is it possible to fill the scar with filler?

Raffy Karamanoukian, MD, FACS · Answer

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented  scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve  the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture.  Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.
 
Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Nelson Lee Novick, MD · Answer

I am sorry that you have this issue. It is unfortunately a real risk following lip lift surgeries, which is why I typically recommend the use of HA fillers (with or without microdroplet Botox) for a nonsurgical lip lift. Regarding the problem here, I have had gratifying results treating hypopigmented scars following surgery, trauma, acne, etc. using a combination of manual microneedling (no need for the added expense and risks of RF microneedling) accompanied by the topical application of Rx topical pigment promoters, such as topical tyrosine and lanatoprost. For the indented portion of the scar, simple subcision, which I have been performing since 1995, can be used to elevate and smooth the indentation and can be performed prior to the aforementioned microneedling. Just fyi: fraxel lasers and RF devices and so many other of the expensive, here-today-gone tomorrow "bells and whistles" gizmos being hawked out there are unfortunately supported far more by marketing hype and social media buzz than hard science. So, "buyer beware" when considering these. You would be wise to consult with an experienced, board certified cosmetic dermatologist scar treatment specialist. Hope this helps and best of luck.

Lip lift scar treatment - will laser resurfacing help?

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