Tethered appendix scar, can it be untethered without reopening the scar? (Photo)

Question

I had a ruptured appendix in 1996 and was left with a tethered scar on my abdomen. The line of the scar is actually not that bad but it’s very indented and shadowed. Is there a way to untether the scar without reopening the scar completely? Is it possible to go through my belly button and just release it? I have 4 small children and looking for minimal down time and risk.

Nelson Lee Novick, MD · Answer

Before jumping to anything more aggressive, such as revision surgery, etc., you may wish to consult with an experienced, board certified cosmetic dermatologist scar specialist to investigate subcision, a non-surgical, minimally invasive technique for elevating and smoothing all kinds of tethered, indented scars from all causes (including post-surgical, as in this case) in all skin types. I have personally been performing this technique since 1995 with gratifying results. Hope this helps and best of luck.

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 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 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

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