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Of course, there is no substitute for seeing the scar up front and personal. In general, however, scars similar to the one shown in the photograph may respond well to a combination of therapies. Subcision is very useful for freeing up the overlying tissue from the thick underlying scar tissue, allowing the surface to "float" upwards and for new, healthier collagen to fill in underneath and raise up the depressed area. If after a series of subcisions (usually between two to four sessions spaced at six week intervals), the base of the scar is not sufficiently raised, a small amount of filler may be added. In my experience, fillers work best for scars folliowing subcision, since the tissue underneath is looser (less bound down) and can more easily respond to the lift of the filler. Since the surface of a scar is usually discolored, as well (typically ivory white or off-white in mature scars, and occasionally crinkly), an additional technique devoted to improving the surface characteristics may also be needed. For this purpose, I prefer medical microneedling (dermarolling), which may also entail two to four sessions with a six week gap between them. The fine microneedles used in this technique break up the surface tissue and allow the new tissue that forms in response to better blend with the surrounding normal skin in both color and consistency. Finally, if there is concern that muscular activity may be contributing to the spread of the scar, tiny drops of Botox, Dysport or Xeomin may be injected very superficially in around the treatment area to diminish this and improve healing and the ultimate cosmetic result.
I think that you would be pleased with the results from having a filler injected below the scar. Personally, I like Silikon 1000 for this problem. This could be combined with a resurfacing procedure such as a chemical peel or a laser.
The picture here does not look like the kind of scar tha I use subcision for. This looks like a "spread scar" that is often seen in scars where muscles are very active. Good luck to you.
Cellulite is caused by a number of factors, including the structure of the ligaments that tether the skin, abnormalities of the fat compartments, and thinning of the skin allowing the fat to bulge. The fact that it isn't a single cause makes it a very challenging condition to treat, and if...
Our office has many different treatments for acne scars depending on the depth of atrophy or hypertrophy. Acne scars require a combination approach using our HIDEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce...
Scar revision that requires excision and rearrangement such as Z-plasties and running W-plasties are done by plastic and dermatologic surgeons, but typically, subcision and punch grafts (the latter usually as a prelude to resurfacing with Fraxel or Dermabrasion or ablative CO2 laser) are done by...
