Can these scars behind ears, 2 yrs after lower facelift, be corrected? (Photos)

Question

I always where my hair up and am very self conscious about my hairline scars. I am over 2 years out from surgery and have tried a variety of lasers (IPL, Skin pen, Hero/Halo) no change. I am hoping there is a solution.

Nelson Lee Novick, MD · Answer

I have had gratifying results using manually performed dermarolling microneedling during which Rx prescription pigment enhancing topicals, such as tyrosine, are applied. It has been my experience that Skinpen provides a relatively superficial microneedling experience best used for facial prejuvenation and maintenance particularly for younger persons interested in maintaining their skin from an anti-aging perspective. By contrast, hypopigmented scars require a more aggressive dermarolling treatment with more deeply penetrating needles, as well as dermarolling of some of the peripheral normal skin (in order to pick up and autotransplant some pigment producing cells into the scar tissue--which by itself is devoid of all but scar collagen), so that these cells can then be "fed" the material needed to make pigment, i.e. by the Rx topical pigment enhancers applied during the procedure.  
I am not at surprised by the lack of success of the energy-based gizmos previously tried, as the hard science to back up the use of these devices lags well behind the marketing hype and social media buzz to promote them. 
The development of stretch scars and stitch tracks are among my concerns about further surgery to treat this problem.
You would be wise to consult with an experienced, board certified cosmetic dermatologist scar treatment specialist and best of luck.

Raffy Karamanoukian, MD, FACS · Answer

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

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

Anna Chacon, MD, FAAD · Answer

Thank you for sharing your experience. It's understandable to feel self-conscious, especially when your hairstyle exposes the area. While some degree of scarring is common after a lower facelift, visible or poorly healing scars behind the ears can be especially frustrating, particularly when standard treatments like IPL, microneedling (SkinPen), and laser resurfacing (Hero/Halo) haven’t yielded results.

At over two years post-op, the scars are considered mature, which can make them more resistant to noninvasive modalities. However, you may still have options. Scar revision surgery is one potential solution, where a skilled surgeon excises the existing scar and re-approximates the skin more precisely to minimize visibility. Additionally, camouflage techniques, such as medical-grade tattooing or dermablading, may offer improvement in color mismatch.

Each scar and skin type is unique, so evaluating the texture, thickness, pigmentation, and tension of the scar is key to determining the best next step. While you've tried many of the standard approaches, surgical revision might provide the improvement you're looking for when lasers haven’t helped.

Can these scars behind ears, 2 yrs after lower facelift, be corrected? (Photos)

Answers (3)

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