How to make atrophic scars on nose less noticeable? (photo)

Question

In order to remove two small vascular lesions on my nose I got laser, but they burnt me and now I have this two scars left, the one on the top is more noticeable because its in the middle of the nose. The other, in addition to be a bit sunk, its also red. How can I make them go away? I have heard about fillers, a doctor commented on plasma gel, what do you think? I would be grateful for your answer...

Nelson Lee Novick, MD · Answer

First let me so how sorry I am for the problem you have. I am not a laser fan in the first place, and that includes fraxels and IPLs, and in general find them to be generally disappointing, expensive, and far more backed by device manufacturer marketing hype than hard science.As to the two scars that have resulted from your prior laser treatment, in my experience these may respond well to subcision, a simple, quick ( literally would take about three minutes to do both atrophic scars), painless (performed under local anesthesi) and inexpensive technique for promoting new, native collagen synthesis under the scar to help plump it up flush with the surface of the surrounding skin. If deemed necessary, a small amount of biostimulatory filler, such as Radiesse, may be injected following subcision to give immediate aesthetic improvement and to further stimulate new, native collagen production. Just yesterday I performed this same procedure, with very gratifying results, on a circular atrophic traumatic scar in the center of the chin of 22 a year old man.

Raffy Karamanoukian, MD, FACS · Answer

Our office has many different treatments for acne scars depending on the depth of atrophy or hypertrophy. Acne 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 acne 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 acne scars and indented acne 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 been 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 laser 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 acne 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

Michele S. Green, MD · Answer

Atrophic Scars are best treated with fillers.  I have great results with Restylane in filling acne scars, chicken pox scars, or scars from skin cancer surgeries.  I have had many patients who have complained to be of disappointing results from PRP performed in other offices.  Restylane usually only costs one syringe to correct multiple areas and is a quick and easy way to minimize the look of these scars.  For the best results please consult a board certified dermatologist with experience with treating scars.

Benjamin Barankin, MD, FRCPC · Answer

There are many things to try and improve an atrophic scar, from subcision, to dermaroller, to electronic dermastamp, and fractionated ablative lasers (e.g. ProFractional). In some cases using fillers or excision are required. Commonly with any type of scar, 2-3 types of treatments may need to be tried to get optimal results. I'd have to see and feel the scar more closely to decide the best option in your case.

How to make atrophic scars on nose less noticeable? (photo)

Answers (4)

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