Would scar removal surgery minimize the appearance of an indent on the tip of my nose? (photos)

Question

I’ve had 3 treatments with fractional laser already but not seems like it’s improving. It is really bothering me since it is in the middle of my face - so I was wondering if I could get better result with a minor surgical excision if my scar is suitable for such a procedure?

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

Nelson Lee Novick, MD · Answer

I am unfortunately NOT surprised by the lack of success with the fraxel lasers treatments. I have been cautioning my regular followers for years already that the hard science to support the use of these lasers, as well for many other expensive, supposedly "next big thing" gizmos out there, such as RF and ultrasound treatment devices, lags woefully behind the heavy marketing hype and social media buzz to promote their use. Sorry.
I would be reluctant to advise surgical revision surgery, since, especially in areas of static or dynamic tension of the skin, there is a significant risk for the subsequent development of stretch scars and even unsightly tram track-like stitch marks.
You may wish to consult with a board certified cosmetic dermatologist scar treatment specialist about the use of a fine needle subcision (which requires no scalpel cutting) to elevate and smooth the scar and the use of professionally performed manual microneedling (no need for the added expense or risks of RF microneedling) to better blend the superficial surface color as well as the texture of the scar with that of the surrounding normal skin. Hope this helps and best of luck.

Would scar removal surgery minimize the appearance of an indent on the tip of my nose? (photos)

Answers (2)

Recommended reading

Everything you need to know about Scar Removal Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.

Would scar removal surgery minimize the appearance of an indent on the tip of my nose? (photos)

Answers (2)

Browse related questions

Recommended reading

Everything you need to know about Scar Removal Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.