Chicken pox scar on the right tip of nose? (photo)

Question

I have an old chicken pox scar on the right tip of my nose. What would be most successful treatment plan? What would be average cost in NY/NJ area? Is it best to go to plastic surgeon or dermatologist?

Nelson Lee Novick, MD · Answer

There are a number of methods for improving depressed (atrophic) pox scars. Through the years I have found subcision, which takes only minutes to perform, to provide relatively rapid and gratifying and long-term improvement.Subcision, a procedure, performed under local anesthetic, that entails using a sharp needle-like device is first inserted to break up the scarred, heavily fibrotic tissue that makes up the base of the scar. Immediately following, a small amount of volumizing material is injected into the potential space just created by the prior procedure. An immediate lifting is seen and the area can be smoothed flush with the surface resulting in the immediate, gratifying improvement seen. As an added plus, six to eight weeks later, neocollagenesis (new collagen formation) occurs in response to both the subcision procedure and the presence of the volumizer--contributing to a  much longer lasting improvement. The entire procedure takes no more than five minutes to perform, requires no scalpel cutting or stitches and entails no significant downtime.If necessary, either immediately following the subcision, or at a subsequent treatment session, a volumizing filler, such as Radiesse can be injected directly underneath. This not only results in immediate lift and smoothing, but itself also stimulates additional new collagen synthesis four to eight weeks down the road.

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

Michele S. Green, MD · Answer

The scar on your nose can be helped with two methods.  The first method would involve injecting a filler into the area and lifting up the depression.  The second method would be using the Ematrix Laser which would help get rid of the scar and build collagen in that area. It may take 3 or more treatments of the Ematrix depending on the depth of the scar. Scars are sometimes difficult to treat but your scar can not be "cut out" by a plastic surgeon since this would make things worse.  Please find a board certified dermatologist who can assist you.

Chicken pox scar on the right tip of nose? (photo)

Answers (3)

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