3rd-degree burn scars, currently have a skin graph on my hands - what are my options? (photos)

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

Hello! Your hands look great considering how bad your burns were. That being said, the hands (and particularly the webspaces between fingers) are prone to developing contractures that limit the movement of the fingers. This is called a burn scar contracture and webspace creep, the latter of which also happens after reconstructing fingers that are congenitally stuck together (i.e. syndactyly). One of the best and most straightforward ways to treat this is with a small procedure to break up the straight scar cord. Plastic surgeons will often use z-plasties, w-plasties or similar local tissue rearrangement techniques to break up the scar line so that the contracture is not so tight between the fingers. Fat grafting can also be helpful to help make the skin grafted skin more pliable - although it is usually limited how much fat graft can be transferred due to the scarring of the skin graft to the underlying tissue. I would recommend that you see a plastic surgeon with formal fellowship training in hand surgery for this. After either or both procedures, you will likely need to undergo hand therapy and possibly splinting to maintain the new webspace motion between your fingers. Wish you all the best!