How can I reduce the scarring? Do you suggest I try laser? I've also done the needling too. (photo)

Question

I had an accidental fall in 2013. Had surgery in 2015 to replace the philtrum with skin from behind my ear. There is still scarring and the one side had a bump that I can't see to get rid of. Do you suggest I try laser? I've also done the needling too.

Kimberly Butterwick, MD · Answer

Thank you for your question and photos. While it is difficult to make a thorough assessment from pictures alone, I can tell you that scar revision is a highly customizable process that often requires a combination of treatments to achieve an optimal outcome. In my practice, we offer more than 45 lasers as well as RF microneedling so that we can tailor scar revision treatments to the precise needs of each patient. In your case, it appears there is a nodule of scar tissue on the right side. A firm bump of this type is often treated with a VBeam laser followed by an injection of Kenalog and 5-fluorouracil. After a series of treatments, the bump will often disappear. Make sure you work with a board-certified dermatologist who has the experience and expertise to produce the best result for you.

Mitchel Goldman, MD · Answer

Scar revision is a procedure that needs to be carefully tailored to the unique needs and skin tone of the individual patient to ensure the best possible outcome. A combination of treatments is also the best approach in most cases. In my practice, we have more than 45 lasers that allow us to customize treatments for our patients to achieve optimal results. You may respond best to one of these laser treatments combined with RF microneedling. However, you will need an in-person assessment to know for sure if this is the best choice for you.

Ken Dolynchuk, MD · Answer

Thanks for the question and photos.  You have a fairly good result but the only way to effectively flatten the remaining areas is with an erbium resurfacing laser. It will reduce the height in one session. The downtime will be significant requiring ointment for approximately 1 week. Make up will then be able to hide residual redness which may persist another 3-4 weeks. Contact a board certified plastic surgeon with experience in this technology and get further information. Good luck.

Shobhan Manoharan, MBBS, FACD · Answer

Combining fractional ablative (eg co2) or non-ablative (eg Fraxel 1550) for the scar with some injections of steroid +/- 5 flourouracil for the thicker component should improve your scarring significantly.  Seek an experienced specialist.  Best wishes, Shobhan.

How can I reduce the scarring? Do you suggest I try laser? I've also done the needling too. (photo)

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