Patient interested in both surgical scar revision and rhinoplasty (Photo)

Question

I am a 28 y/old female with an indented scar on the right tip of my nose. The wound arose in January 2023 (ingrown hair patch resulting from eyelash serum) and only healed this summer after electrolysis. Ive had minor improvement from RF microneedling and laser but not substantial. I’ve had conflicting advice from various surgeons about what is possible but am only interested in permenant solutions. I’m also interested in rhinoplasty to lift the tip. Can anyone help my case? Willing to travel.

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

Nelson Lee Novick, MD · Answer

Subcision, which I have been performing for all kinds of indented scars since 1995 is a simple, relatively inexpensive technique for elevating and smoothing all kinds of indentations and indented scars. It has a proven safety and efficacy record for use in all skin types and engenders little to no significant downtime. By stimulating new collagen and new elastic fiber synthesis the results of subcision are long-lasting to permanent. You would be wise to consult a board certified cosmetic dermatologist scar treatment specialist with extensive experience in performing subcision. As most venues are into hawking expensive fraxel laser and RF treatments these days, despite the fact that the hard science to back up their use lags far behind the marketing hype and social media buzz to promote them, you will have to make a special effort to find practitioners experienced in subcision. Hope this helps and best of luck.

Patient interested in both surgical scar revision and rhinoplasty (Photo)

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