Scar removal - do I need surgery or something less invasive to correct the problem? (Photo)

Question

I have a scar above the bridge of my nose that I've had for a long time. It was fine until I got older and the skin started to bunch up around the scar. I would like to have it corrected but I'm not sure if it requires surgery of something less invasive to correct the problem.

Raffy Karamanoukian, MD, FACS · Answer

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Gary M. Horndeski, MD · Answer

You may benefit from scar revision or the other alternative is dermal fillers to correct the contour deformity.

Best Wishes,

Gary Horndeski, M.D.

Nelson Lee Novick, MD · Answer

Consider subcision to elevate and smooth the scar; HA filler for added benefit to additionally stimulate new collagen and elastic fiber production (not for so-called "spacing," as often mentioned on sites like Dr YouTube & Dr. Google). Botox can be used in this area to temporarily decrease motion, which would allow for better response to the subcision. You would be wise to consult with a board certified cosmetic dermatologist scar specialist. You would also be wise to exercise a great deal of buyer beware when you are being hawked expensive "bells and whistles" treatments, like fraxel lasers and RF devices, as the hard science to back up their use lags woefully behind the heavy marketing, sales hype and social media buzz to promote them. Best of luck.

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