Is Fraxel Laser a Recommended Option for Blepharoplasty Scars? (photo)

Question

I had an upper and lower blepharoplasty 6 months ago. I have scaring complications on one eye. My doctor has recommended fraxel laser to improve the scaring. Is this a recommended option. If so which fraxel laser is better to treat this scar fraxel repair or fraxel restore? If laser is not recommended, what are my options? Thank You.

Raffy Karamanoukian, MD, FACS · Answer

Plastic surgery scars require attention after surgery so that they remain cosmetically-appealing and barely noticeable. In our office, we use a protocol for scars that minimizes their activity in the 6-8 weeks after surgery. If you have late plastic surgery scars, you may also require laser and RF therapy to help reduce the longterm effects of the scarring. Keloids, hypertrophic scars, widened scars, red scars, and hyperpigmented scars all require scar modulation with topical creams followed by lasers and RF therapy. Topical skincare should be directed to a specific need, whether for pigmentation or hypertrophy and our office can guide you through the process to obtain the correct Plato’s Scar cream or Melarase cream for hypertrophy and discoloration. In terms of lasers, we would employ the vbeam laser for redness, Venus Viva RF, PRP microneedling, chemical peels, and Morpheus 8, fractional erbium, or fractional co2. All of these have their individual benefits. Most of all, we recommend you visit a solid plastic surgeon who understands surgical scar revision, laser therapy, and RF therapy for scars. 
 
Best, 
Dr. Karamanoukian
Realself100 Surgeon

William Groff, DO · Answer

If I were treating your scars, I would use the Fraxel Repair or the Restore.  The Fraxel lasers had been studied and published in scientific journals more than any other fractional device on the market.  There are many of these publications on scars specifically. The Fraxel lasers can penetrate up to depths of over 1.5mm or 1500 microns, although this is not necessary for all scars.  I would also consider using the Vbeam Perfecta and injections to treat your scarring as well. 

	Take care, 

	Dr. Groff

Jennifer Reichel, MD · Answer

Fractional lasers can be used quite effectively for scarring (surgical, trauma, acne etc). For your blepharoplasty scar, you certainly could use the Fraxel laser. The Fraxel Restore is an Erbium laser (1550 wavelength). The Fraxel Repair is a CO2 laser. The difference is that the Erbium laser is coagulating, and the CO2 laser is ablative. So - which to use. Regardless of the brand of the laser, both types can be effective. The Fraxel Restore will likely take 3-6 treatments to see really great results. A fractional CO2 laser will probably take 1-2 treatments for good results. Both should be safe on light skin types, but there are more risks with the CO2 laser overall. However, if you need to have an eyeshield put into your eye for the treatment, you may want to go with the CO2 because it will take less treatments (and eyeshields aren't much fun, and do have the unusual risk of scratching the surface of your eye ball.

Harold J. Kaplan, MD · Answer

Hi Beira.  You and your surgeon are on the right track with fractional lasers.  We prefer the Sciton Profractional to the Fraxel lasers because of the different wavelength (Erbium - 2940), higher absorption in water (the target for this procedure) and because of the greater depths we can treat to with the Sciton.  With scar tissue, a key issue is to be able to treat to the base of the scar to loosen and soften the tissue.  The Sciton allows us to go as deep as 1.2 MM (1200 microns) when treating scar tissue and this is important factor when looking at the potential results.  Good luck.

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