What is the most efficient scar removal for laparoscopy incision scars?

Question

What type of scar removal treatment do you recommend for laparoscopic scars (~1 cm lines)? How soon after a laparoscopic procedure can these incision marks start to be treated in order to create the least amount on long-term scarring? Consider a patient prone to both hyperpigmentation and hypertrophic scarring.

A. David Rahimi, MD · Answer

Dear patient, Laparoscopic scars can sometimes be indented, thickened or hyper or hypo-pigmented. Every patient heals differently. 4-6 weeks after the procedure is the ideal time to have the scars treated. I discuss the treatment options with my patients. If the scar has adhesions and is bound down a couple of sessions of Subcision or micro-needling is helpful to release the bands. If the indentation is very deep a long lasting filler such as Juvederm Vollure or Voluma is very helpful (occasionally I do the permananet filler Bellafill). Finally, to remove the actual scat 3 to 5 sessions of Mixto fractioonal ablativelaser is very helpful. This laser is preferred in clients with darker skin or sensitive skin. I hope this was helpful. Yours Dr David R.

Raffy Karamanoukian, MD, FACS · Answer

Keloid scars are characterized by their growth potential and increased degree of inflammation within the skin. Unlike non-inflamed scars, keloids have the potential for growth beyond the original footprint of injury. Our office specializes in the management of keloids, whether single or multiple, using a combination platform that includes lasers, RF, scar modulation, Parke-Davis Scar Protocols, and injection therapy. Some keloids will require surgical intervention as an initial step for treatment.

Massaging your scar can reduce inflammatory mediators that are responsible for chronic inflammation and scar overgrowth. It’s a rather simple technique that inactivates celluar inflammation mechanisms that can lead to keloid and hypertrophic scars. Start by applying a thin coat of Plato's Scar Serum twice daily to the scar and gently massaging the scar footprint. Be gentle, taking care not to slough off newly formed skin and reducing shear force on the dermis. This is ideal for new and old scars. 
•	Twice daily application of a scar gel. 
•	Scar modulation with gentle massage.
•	Intralesional injections in case there is overgrowth of scar tissue.
•	Vascular lasers for neovascularization of scars.
•	Stimulatory injections for scar atrophy. 
Scar gels work well, but should be combined with a physician-directed protocol to reduce scar formation and reduce scar visibility.

Best, 
Dr. Karamanoukian
The Scar Doctor
Realself100 Surgeon

Sabrina Fabi, MD · Answer

Hello and thank you for your question. While laparoscopy scars are small, they can be bothersome if they are too prominent. The care of scars can begin soon after your procedure, using a variety of techniques to enhance the healing process. Once the wounds are fully healed, there are additional revision therapies that can be used to reduce the appearance if you are unhappy with it. I encourage you to meet with a board-certified cosmetic dermatologist as soon as possible to assess the current condition of your scars and create a treatment plan customized to you. Good luck to you!

Daniel Barrett, MD · Answer

Dear Anna617,
it is hard to tell for sure without an examination. Scars can improve with laser treatment, corticosteriod injections, microneedling, prp, revision surgery. If you are considering a treatment, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Ken Dolynchuk, MD · Answer

Thanks for your question. I would agree with all the other responses given already, but it is a recommendation to use subcision with structural fat grafting in one session and then 6 weeks later perform fractional laser to the remaining surface of the scar to reduce it even further.This has the effect of firming and texturizing the scar to look more like the surrounding skin. Find a board certified plastic surgeon to do this for you.Good luck.

Ryan Couvillion, MD · Answer

Any violation of the skin is going to leave a scar and there is no way to completely avoid this.  There are definitely ways to improve the healing process and/or start over under ideal conditions.
After a wound heals, the scar continues to remodel and change for months.  There are many treatments to improve the character of scars during the healing/remodeling process - lotions, silicone sheeting, and sun avoidance to name a few.  
If the scars are mature and are still pigmented and unsightly, a laser treatment may be appropriate to lighten the color of the scar.  Another option would be a scar revision by a qualified surgeon with the specific goal of starting the process all over again and using the treatments I listed above while this is healing.

What is the most efficient scar removal for laparoscopy incision scars?

Answers (6)

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