Laser chemical peel and neck, what would be my best option? (Photos)

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

At least from the photos provided, it appears that the predominant and most visible problem on the neck are the prominent, encircling, horizontal  "necklace lines."  For many years now, we have been successfully treating these via a combination of the use of a filler to elevate the depressions and microdroplets of a neuromodulator, such as Botox to release the neck muscle responsible for their developement.  Beletoro is my choice for this in my Upper East Side Manhattan office, since it possesses little to no tendency to give rise to the unwanted, bluish Tyndall Effect when injected superficially into the delicate tissues of the neck.   Teosyal Redensity II is my choice in my Israel satellite facility, where a far greater number of regulatory agency approved fillers are available. The crepey appearance of the decolletage and the tree-like fanning pattern of fine lines can also be relatively easily addressed with the use of products, such as Restylane "Skin Boosters" and Princess Filler (Israel) or Juvederm Ultra XC (NY) all of which are intended to hydrate the chest and to smooth the area directly and via biostimulation of new native collagen and elastic fibers. Relatively expensive laser treatments tend to be far more backed by device manufactuer supported marketing hype than hard science. The in-office use of a relatively inexpensive series of superficial peels accompanied by the at-home use of prescription strength topical retinoids and and alphahydroxy acids can further help to combat sun damage textural and pigmentary irrergularities, as well as help to maintain and prolong the results of the above treatments.  Best to consult with a board certified aesthetic physician and make sure to ask to see his/her before and after photos before agreeing to proceed. Best of luck to you.

If you are looking to go the non-surgical route, I would consider Ulthera. This is a tightening procedure utilizing focused ultrasound waves. It is now FDA-approved for the neck and chest. It can also be done in conjunction with other therapies like laser resurfacing and microneedling for optimal results.