How to fix this scar? Tried CO2 with no change. (photos)

Question

I laser on the tip of my nose to remove a dark spot on my nose, however the laser treatment left a deep scar on my nose. I tried the CO2 treatment on my nose twice and the scar didn't change. What are some other options that I have to make it disappear?

Raffy Karamanoukian, MD, FACS · Answer

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

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Thomas A. Pane, MD · Answer

A small depressed scar like this is a challenge, but there are good options.  CO2 is one option as are direct excision and subcision and treatment with fillers.  As the scar cannot be completely removed,the goal of treatment is to make the scar less noticeable.

Jason Emer, MD · Answer

This needs a combination approach. I recommend lasers, microneedling/prp, subcision for blending and fillers. I recommend getting a formal evaluation with a facial scarring expert. Best, Dr. Emer

William Marshall Guy, MD · Answer

Hello b_m79,Your scar looks to be a divot.  Given the location it catches the light and becomes quite noticeable on the tip of your nose. Whatever treatment you do it needs to involve either removing the divot or trying to raise the divot.  Cutting out the old scar may be the most effective.  This will replace the divot with a line and depending on how you heal, it can look great or still be noticeable.  You can try to raise the tissue up with subcision (essentially using a needle below the scar to try to free it up) and then inject filler below the scar to keep it elevated.  This may be permanent but sometimes as the filler dissolves the area falls back down and there is no long term change.  The use of lasers can help once it has been raised up.  However, I would not recommend you use any lasers at this point as they are more for camouflaging the scar and won't do much to raise up that area. I'd recommend you consult with a facial plastic surgeon to go over the various options and see which one is best for you.I hope this helps and good luck.

Ramtin Massoudi, MD - Account Suspended · Answer

Hello Dear
Acne scar is very hard toget rid of, CO2 laser is good start, you might need 5 times, you can combine it With Fillers like Bellafill or other fillers
Thank you
Ramtin Massoudi, MD

How to fix this scar? Tried CO2 with no change. (photos)

Answers (5)

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