How to smooth this scar tissue from extractions 10 years ago? (photos)

Question

Had extractions when I was 19 while on accutane per my derms instructions (now know that was a terrible idea). I've been getting Botox since I was 20 (now 29) so they are not wrinkles. I've tried Botox, filler, microneedling, fibroblast, chemical peels. Nothing is strong enough to make the slightest difference. I am looking for a solution to tighten this skin so it's smooth - lasers, surgery, anything.

Raffy Karamanoukian, MD, FACS · Answer

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Jason Emer, MD · Answer

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in person or virtual consultation to develop a custom and effective treatment plan.  It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

Shanthala Shivananjappa, MD · Answer

The gold standard for treating acne scars are energy-based treatments. Subcision in the forehead can be difficult. I would treat a forehead scar from extractions, using lasers and exosomes instead of fillers. Laser treatments can help to resurface the skin, reduce scarring, and promote collagen production. Exosomes can be used to stimulate cellular regeneration and promote healing in the treated area. This combination of treatments can help to improve the appearance of the scar without the need for fillers. It is important to consult with an experienced physician to determine the best treatment plan for your individual needs.
It is important to note that using filler injections in the forehead carries potential risks, including the risk of blindness. Injecting fillers into the forehead can cause blockages in blood vessels that supply the eye, leading to a condition called retinal artery occlusion, which can result in permanent blindness. Therefore, I prefer laser treatments and exosomes are often preferred for treating forehead scars as they do not carry the same risk as fillers injections. However, it is important to consult with an experienced physician to determine the best treatment plan for your individual needs and to discuss the risks and benefits of each treatment option.

How to smooth this scar tissue from extractions 10 years ago? (photos)

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