Scar revision after cyst removal - what is the best way to improve this? (Photos)

Question

Hello! I am 24 years old from france. 4 months ago I had a scar removed the scar was due to a recurring abcess that would get infected every year or two. The scar was not big but the doctor had to remove quite a large part because there was cyst sinuses all over the line. Now i have this scar half of it healed well , some parts almost invisible. However the bottom got quite large (right over my jaw muscle, probably the reason). It was already a bit enlarged 7 days after surgery when removing the stitches tho. Now some doctors Recommendations are : some say wait.Some say laser. Some say injections. Some say surgery. Some say massage. Some say injection AND laser. I am confused. I wanted to know if it would be possible at around a year post op to have revision only of the bottom part ? My non-surgeon mind tells me it would be much lighter than excising all of it when the rest healed very well, why hurt good scar part ? The scar is not flat, its like a finger under the skin, lumpy. However this lumpiness has greatly reduced since 3 months, but veery slowly. I am saying this because this is maybe why some say injections. I do have some swelling/lymph/oedema/Fibrosis or whatever it is. Like a finger under the scar. Maybe it could impair partial revision. Should i start a few rounds of co2 laser and if i am not satisfied with bottom part get new stitches only for that part ? I dint find examples of this online. Thank you have a good day

Raffy Karamanoukian, MD, FACS · Answer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser.  Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.  
Best,
Dr. Karamanoukian 
Realself100 Surgeon

Anna Chacon, MD, FAAD · Answer

It is safe to get dermal fillers while taking Lamictal (lamotrigine) because there is no known pharmacologic interaction between lamotrigine and commonly used fillers such as hyaluronic acid or calcium hydroxylapatite . Lamotrigine does not affect clotting, infection risk, or wound healing in a way that would increase filler complications. Standard filler precautions apply: use an experienced injector, ensure sterile technique, and monitor for rare hypersensitivity or infection. If you have a history of keloids or abnormal scarring, discuss this with your injector, but lamotrigine itself is not a contraindication.

Pharmacological considerations
Lamotrigine is an anticonvulsant and mood stabilizer that does not significantly affect coagulation, platelet function, or wound healing — factors relevant to filler safety. There is no evidence of pharmacokinetic or pharmacodynamic interactions between lamotrigine and dermal fillers.

Clinical evidence and expert opinion
There is no published clinical evidence or expert guidance indicating increased risk of complications with dermal fillers in patients taking lamotrigine. Standard filler precautions apply regardless of lamotrigine use.

Potential risks and complications
Dermal fillers carry general risks — bruising, swelling, infection, and rare hypersensitivity — but lamotrigine does not increase these risks. There is no evidence that lamotrigine increases the risk of keloids or abnormal scarring, which are sometimes considered in filler planning.

Precautions and recommendations
Choose an experienced, licensed injector who uses sterile technique and high-quality products.
Disclose all medications, including lamotrigine, and discuss any history of keloids or abnormal scarring.
Follow post-procedure care to minimize bruising and swelling.

Conclusion and clinical recommendation
It is safe to receive dermal fillers while taking Lamictal (lamotrigine). There is no known interaction between lamotrigine and dermal fillers, and lamotrigine does not increase filler-related risks. Use standard precautions and select a qualified injector.

Scar revision after cyst removal - what is the best way to improve this? (Photos)

Answers (2)

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