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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
Scar laser treatment can be performed after plastic surgery once the surgical site has fully healed and there are no open wounds or scabs present. The timing of when to begin laser scar treatment can vary depending on the type and extent of surgery, as well as the individual patient's healing process. In general, it is recommended to wait at least 2 to 3 months after surgery before starting scar treatment.
I thought it might be helpful for you as a cautionary note to read the answer I literally just finished writing in response to another Realself questioner who underwent a C02 laser treatment to improve an old scar on the chest. and who subsequently developed a hypertrophic scar.:"I'm really sorry that this has happened to you. It's frustrating to me, however, since I continually caution people to exercise a healthy dose of "buyer beware" when considering treatments with "bells and whistles" lasers and other so-called energy-based gizmos. At least from the photo provided, the "chunk of collagen" is likely to be a hypertrophic scar that developed in response to the CO2 laser treatment. Fortunately, the use of intralesional injections of an anti-inflammatory agent, triamcinolone has an excellent many decades' long track record for successfully shrinking and flattening hypertrophic scars from all causes. You would be wise to consult with a board certified cosmetic dermatologist. and best of luck."
I recommend lasers as early as six weeks following any surgical procedure if the patient desires. It is worth noting, however, that erythema, or redness, typically peaks in scars after six weeks and will decrease naturally. If possible, I like to wait around 3 months before beginning laser therapy to see if the scar will naturally lose redness on its own.
This type of deformity may be hard to correct but is is possible. In person consultation with a board certified plastic surgeon with experince in lip lifts and nose surgery, is recommended. Good luck.
Providing that patient is from the area and can come for 10-12 day follow up, we use non-resorbable, naylon sutures for skin closure. Different, resorbable sutures are used for closure of deep layers of tissue. Hope this helps.
Stitches come out in 5 days and with applying Lash (laser assisting skin healing) the incisions heal to near invisibility 30% to 40% quicker than without it.
