What is the best procedure to treat a raised scar from a biopsy thirty years ago? (Photo)

Question

When I was 19, I had a biopsy on my lip to rule out cancer, which fortunately it was not. However, the procedure left me with a raised bump and scar. I am now 49 and would like to explore treatment options to reduce or remove the bump and improve the appearance of the scar.

Raffy Karamanoukian, MD, FACS · Answer

Our treatments use combination therapy to improve the epidermis and dermis. We see atrophic and hypertrophic scars, as well as scars that have hypo and hyperpigmentation. 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 discuss the best treatment options for your type of skin. .

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Kyle Kimura, MD · Answer

Thanks for your question and photo.
I'll be completely honest, that doesn't look like a scar. That looks more like a mass and I would strongly recommend seeing a plastic surgeon, ENT, or possibly a dermatologist to look at that area. It could be the angle of the photo, but the degree of the raised area under the skin is very atypical for the majority of scars I have seen. 
I hope this helps and best of luck,Kyle Kimura, MD

Anna Chacon, MD, FAAD · Answer

Hi! First, it’s great to hear that your biopsy turned out well. A raised scar—even one from many years ago—can often be improved, though the approach depends on the type and thickness of the scar as well as its location on the lip.

Here’s a general overview of options:

Laser treatments – Fractional CO₂ or Erbium lasers can soften raised scars and improve texture and color over time. Multiple sessions may be needed for optimal results.

Steroid injections – For scars that are thick or firm, a series of corticosteroid injections can help flatten the bump and reduce redness.

Scar revision surgery – In some cases, a small surgical revision can remove the raised tissue and realign the scar for a smoother appearance. This is especially considered for scars that are long-standing and resistant to non-surgical methods.

Combination approach – Sometimes, a combination of minor surgery followed by laser or other therapies gives the best cosmetic outcome, especially on delicate areas like the lip.

Even though the scar is decades old, it’s never too late to see improvement. The key is a personalized plan based on the scar’s thickness, your healing tendencies, and your cosmetic goals.

Nelson Lee Novick, MD · Answer

If close-up examination and palpation confirm that this is indeed simply an elevated scar, then the use of intralesional injections of an anti-inflammatory agents, such as triamcinolone has a several decades' long track record of efficacy and safety for flattening hypertrophic and keloid scars. You would be wise to consult with an experienced, board certified cosmetic dermatologist scar treatment specialist and best of luck.

Laser Skin Solutions - Portland · Answer

Dealing with a raised, persistent bump and scar on the lip three decades after a biopsy can be quite frustrating, especially since scars of this age are fully mature, stable, and resistant to fading or flattening on their own.
As an advanced licensed aesthetician in Portland, I frequently consult with individuals evaluating long-standing scars on delicate facial areas like the vermilion border and lips. When addressing a hypertrophic scar or fibrous papule resulting from a past biopsy:
Understanding Scar Maturation: After 30 years, the collagen fibers within the scar have organized into a dense, permanent structure. Topical silicone sheets, massage, or basic surface creams will have virtually no impact on reducing the elevated volume at this stage.
Surgical Revision Options: A formal scar revision performed by an experienced plastic surgeon or dermatologic surgeon can surgically excise the raised tissue, meticulously re-approximating the lip margin to create a smoother, flatter contour.
Laser and Energy-Based Resurfacing: For blending margins and refining surface texture post-revision, fractional ablative lasers or targeted radiofrequency treatments can help remodel surrounding tissue. Additionally, treatments like our clinical microneedling protocols can sometimes be integrated into a comprehensive scar management plan to improve adjacent skin quality and collagen alignment.
Because the lip is a highly visible, mobile, and vascular structure with unique skin characteristics, an in-person evaluation with a board-certified plastic surgeon or facial plastic specialist is essential to discuss whether surgical excision or a combination approach is best suited for your lip anatomy.

What is the best procedure to treat a raised scar from a biopsy thirty years ago? (Photo)

Answers (5)

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