9 Months after scar removal and I'm unsure about healing - should I expect improvement or will I need another procedure? (photo)

Question

I recently had a scar revision on my leg (November) but I'm not sure about how it's healing. I can't tell if it's indented or the sides are raised and will flatten down. It's not how I expected a surgical scar to heal. It has no visible scar line. Does it need doing again?

Anna Chacon, MD, FAAD · Answer

Thank you for sharing your concern. At 9 months post-scar revision, scars can still undergo gradual remodeling, but the most significant improvements typically occur within the first 6–12 months. It’s normal for scars to appear raised, indented, or uneven in texture during this time as collagen continues to reorganize. In many cases, scars will flatten, soften, and fade with time, though the final appearance can vary depending on individual healing, skin type, and the nature of the procedure.

If the scar remains indented or raised beyond a year, options such as steroid injections, laser therapy, microneedling, or a secondary revision may be considered to refine the result. For now, continued patience, sun protection, and scar care (such as silicone gel or sheets) may help optimize healing.

In most cases, scars continue to improve even beyond the 9-month mark, so it may be too early to conclude that another procedure is necessary.

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

9 Months after scar removal and I'm unsure about healing - should I expect improvement or will I need another procedure? (photo)

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