Can scars from dimple piercings be fixed? (photos)

Question

I had my cheeks pierced 10 years ago. I had them in for about 6 months and then removed them. The scars didn’t seem TOO bad but as I’ve aged, I’ve noticed that they have curved into my smile and given me a “wrinkled” look. Is there any procedure that can remove the scars and even out my cheeks so that they’re smooth and don’t have the “dimple” anymore? I don’t mind the round scars but the fact that they make a line into my natural smile line really bothers me. Also, what costs am I looking at? Thanks.

Raffy Karamanoukian, MD, FACS · Answer

Our Hidef protocols for scar revision can address different types of scars, depending on your scar biometrics and characteristics. Protocols vary in duration based on the severity of your scars. 
Bad scars can manifest in many different ways, including pigmentation, thickening, and depression of atrophic scars. Thick scars are best treated in my practice with IIT, cortisone injections, pressure management, and laser. We recommend daily use of Plato’s Scar Serum to the scars to mediate scar hypertrophy. 
Hyperpigmented scars respond well to Melarase AM and Melarase PM creams. If the area is large, consider Luminase and Exfolase creams for the body. Hyperpigmentation PIH can also be treated with Q switch laser, PICO, chemical peels, and rapid scar exfoliation. PIE erythema scars are best treated with pulsed dye laser. 
Keloid scars are our specialization. We manage small and large keloid scars with excision, IIT, PRP, laser therapy, and scar modulation. Use Plato’s Scar Serum daily. 
Textural scars respond well to nanofractional RF and fractional laser to help improve surface texture. When combined with scar modulation, the results can improve dramatically. The most important variable is for you to choose a plastic surgeon with expertise in laser therapy using Hidef protocols. 
Best,  
Dr. Karamanoukian  
Realself100 Surgeon

Nelson Castillo, MD · Answer

Thank you for sharing your question and photographs.  These can be improved upon but will require additional surgery to remove the tract of your piercing as well as release the surrounding scar tissue.  Interposition of either fat or filler would also be of benefit.  Hope this helps.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  Based on
your photographs, you may benefit from a surgical scar revision.  This decision should
be based on a detailed discussion with equal input from both you
and your surgeon.   Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results.   The most
important aspect is to find a surgeon you are comfortable with. I recommend
that you seek consultation with a qualified board-certified plastic surgeon who
can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.  FACS
Harvard-trained plastic surgeon

Jason Emer, MD · Answer

These can be improved with a combination of surgery and/or lasers and microneedling/prp. I recommend getting a formal evaluation with a scarring expert. Best, Dr. Emer

Regina Rodman, MD · Answer

For piercings that were in for a long time, only excision will work.   It isn't a "scar" so much as an epithelialized tract.  If the piercing was in for a long time there is skin around all the edges of the circle.  It will not go away with just a laser.  The skin tract has to be removed. I have had luck excising the scars with a tiny punch, placing small delicate stitches.  The new edges will heal together.  Further resurfacing with a laser can then be done if the patient wishes, usually 6 months after the excision. Best of luckDr Rodman

Kristine Brecht, MD (license suspended) · Answer

Yes, a combination of subcision and fillers may just do the trick.Occasionally excision of deep piercings and resurfacing techniques are needed.Best. Dr Brecht

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