What is the best treatment for the scarring shown in the photos? (photos)

My wife had a vehicle accident and below her nose and onto her upper lip area has scaring. When we were living in Thailand she would get monthly injections that she said helped with the size appearance and the itching. We are now back in the USA and she is seeking treatment or surgery for this. What are the best options available based on the photos I posted? Can this type of scar be removed or minimized with by surgery or laser or are the injections the best that can be done?

Doctor Answers 2

Facial Scarring Treatment

Thanks for your question and thanks for the photos – they help. And I agree with Dr. Kaplan in that injections of steroids can help the raised areas – but you need to be careful as there is already some skin lightening around the areas where the scars are. But by a skilled injector, these would help. Then fractional lasers are the best way to go. There are non-ablative fractional lasers that work with a series of treatments and minimal downtime. The ablative fractional lasers work faster, but have more downtime. And the new fractional RF microneedles, like the EndyMed Intensif, has shown some very nice results in these situations with a skilled dermatologist or plastic surgeon at the helm. Best of luck.

Nashville Dermatologic Surgeon
4.0 out of 5 stars 18 reviews

Lip and Nose Scar Revision

Hi Overbet.  We would suggest two options for your wife.  The injections would be the starting point, but we would only use them on one small area.  Underneath the right nostril (as seen in the center photo), you can see a small raised area that runs vertically from the side of the nostril and downward.  This ridge of scar tissue could be softened and flattened with Kenalog (an injected steroid).  

Once that small area is injected, we would then pick up with fractional laser resurfacing.  The idea behind fractional laser resurfacing in your wife's case is to make many microscopic perforations in the scar tissue using a laser.  When these small perforations are made, the scar tissue vaporizes from the heat and softer new collagen forms in the void.  Over the course of several treatments this means that the scar tissue is replaced be healthy new tissue.  

While scar revision is never perfect, it appears that she is a good candidate and you could get nice improvement from several DEEP fractional laser resurfacing procedures.  

To see examples of before and after pictures for our Los Angeles patients that have undergone fractional laser resurfacing procedures, please click on the link below.  

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews

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