I have a dent in my butt cheek, upper left side, it feels like a golf ball-sized hole in the collagen. Will laser help? (Photo)

Question

Would laser therapy or microneedling help pull the collagen back together? I don't want a hole forever :( My chiropractor says it most likely a collagen issue. it is discouraging because it feels like a hole in my butt and its rather discolored. It doesn't hurt at all. I am 31 yrs old 5'7 173lbs and 38% body fat. I am on a fitness journey to lose weight. I exercise 4-6 times per week. I usually do barre classes that use a lot of glute muscles. I am curious what cause this seperation of my collagen :(

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

Jason Emer, MD · Answer

Indented scars typically need a combination of fillers, lasers, and microneedling treatments in order to see great results. See an expert to determine what type of combination treatment plan would work best for your case. Best, Dr. Emer.

Ben Brown, MD (license emergency restriction) · Answer

It's difficult to tell from the photos, but that doesn't appear to be a normal area of skin. It appears to be a different color from the surrounding skin. Collagen also doesn't  just "separate" without a known cause. It would be important to know how long this has been there and if it is changing at all. From the picture, this looks like an involuted infantile hemangioma, but again, more information and a physical exam would be needed to make a more educated diagnosis. That being said, microneedling and laser therapy can be used for superficial collagen growth stimulation, but would likely not result in an increase in volume that would be necessary to fill out an area this large. Fat grafting may be a potential option, but doing that safely would require a better idea of what caused the void in the first place. If that is a new change in your skin, my advice would be to have it evaluated in person prior to getting the volume restored.I hope this helps!

Mats Hagstrom, MD (license on probation) · Answer

No one is going to give you a definitive diagnosis or appropriate treatment plan based on your post. And examination and most likely some type of testing is necessary to confirm the diagnosis.
My vote goes towards a vascular malformation. Most likely the venous malformation.
On the picture the area looks blanched. Does it change in color when you press on it?
Your chiropractor clearly didn’t go to medical school.
Jumping into offering treatments with fillers and micro needling without a confirmed diagnosis shows ignorance and a  lack of medical training.
I suggest talking to your primary care doctor and getting a radiographic evaluation. Perhaps start with an ultrasound or ideally get an MRI. An MRI with contrast may be ideal.
Most likely this is not anything dangerous and most likely should
Most likely this is not anything dangerous and most likely should not be treated. 
Why don’t you make an appointment with a competent qualified physician. Start with your primary care doctor.
Best, 
Mats Hagstrom MD

I have a dent in my butt cheek, upper left side, it feels like a golf ball-sized hole in the collagen. Will laser help? (Photo)

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