Epicanthoplasty scar is spread, indented, pink and shiny - how can I treat this? (Photos)

Question

Hello all, i had an epicanthoplasty done 9 months ago. my scar currently is very visible to me without makeup. It has widened and spread to beyond the surgical incision. I am full of regret and i just want to get something to help reduce so i can feel confident again.

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

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

Anna Chacon, MD, FAAD · Answer

Thank you so much for sharing your experience — I know how upsetting it can feel when a scar doesn’t heal the way you hoped, especially in such a delicate area.

At 9 months post-procedure, the scar is still considered active, and there are options that can help improve the appearance, texture, and color over time.

Here are some approaches that are commonly effective:

1. Addressing the widening and indentation
A combination of treatments often works best. Fractional laser resurfacing or radiofrequency microneedling can help remodel collagen, improving both the spread appearance and the small depression. These treatments gradually tighten and smooth the skin so the scar blends better.

2. Improving the pink, shiny look
Persistent redness or shininess means the scar is still vascular and immature. Vascular laser treatments, such as pulsed dye laser (PDL) or IPL, can reduce this redness significantly. Many patients see that “pink” tone fade much faster with these therapies.

3. Softening the scar tissue
If the scar feels firm or raised in some areas, silicone gel or silicone sheets can still offer benefit. Sometimes a small steroid injection is used very conservatively if there’s thickening, but this depends on the scar’s behavior and location.

4. Camouflaging the line
For scars that have widened beyond the incision, techniques like laser blending or even minor scar revision can help reshape the edges so the transition is less noticeable. This is something many patients consider once the scar has fully matured (around 12 months).

5. Realistic expectations
Face scars do improve, especially around the eyes where the skin is thin. Even though it feels discouraging now, most scars continue to soften for up to a year—and often longer. Early intervention can make a big difference in how they evolve.

I’m really sorry this has affected your confidence. You’re not alone in this, and what you’re seeing is something that can be improved with the right combination of therapies. If you take anything from this — it’s that your scar is still very much treatable.

Epicanthoplasty scar is spread, indented, pink and shiny - how can I treat this? (Photos)

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