What is the Best Laser Treatment for Surgical Scars?

Question

I recently had a facial trauma and my forehead split open. The initial scar from the ER was terrible, but the scar has since been revised nicely and is now just a thin red line that is ever-so-slightly indented. Revision surgery was 6 weeks ago and the doc also did subcision two days ago to reduce indentation. I am scheduled for Fraxel on Monday but getting cold feet. Is it the right laser for me? Should I wait and give it more time to see what happens with the subcision? Thanks for your response!

Larry S. Nichter, MD, MS, FACS · Answer

Yes laser treatment early on can minimize the extent of your scar later on including the red color that you describe. There are several lasers that are helpful including Fraxel CO2 ("Repair") but I prefer the Sciton or Diolite lasers for early scar treatment. The best Scar Management is important to minimize or completely hide from view, the telltale signs of your surgery—namely, scars. Both you and your surgeon want you to have the most minimal scarring possible. There are many possible causes for scars that are enlarged or overly red or not healing well. Unsightly scars are most commonly due to genetics, underlying medical conditions, or improper scar/wound care. The last part is very important and patients can make a noticeable difference in their scars’ appearance by following best scar management practices. See below links for additional information.

Benjamin Caughlin, MD, FACS · Answer

I have researched and lectured on this topic. Do not wait. The earlier the better for laser treatments and scars. Fraxel is a fine choice. You essentially want a fractional ablative laser (CO2 or Erb:YAG) and possibly a lower wavelength laser like a PDL 595 nm wv zone if there is redness and hypervascularity.

It will likely take multiple treatments to maximize scar. In my hands the best results are after 5 treatments separated by 4- 6 wks.

Hope this helps.

Best of luck,

DrC

It will likely take multiple treatments to maximize scar. In my hands the best results are after 5 treatments separated by 4- 6 wks.

Hope this helps.

Best of luck,

DrC

Harold J. Kaplan, MD · Answer

Hi Miss_g,
If you just had subcision after having surgical revision only 6 weeks ago, we think it is too soon to be undertaking a Fraxel laser treatment. If the revision and the subcision have worked well in helping wiht the texture, we think the next step would be a pulsed dye laser for the redness. But we usually wait 6 months to give the scar some time to heal.  Infliciting more trauma a tthis time with a Fraxel laser we think is a mistake. Good luck.

Ron Shelton, MD · Answer

I&rsquo;m glad you&rsquo;ve gotten a good result so far from the surgery. Some people recommend Botox in the early phase after surgery on the forehead to relax the muscular pull on the incision. You might want to consider this depending on the exact location of the surgery. Fraxel is a very good and overall very safe treatment, but scars can react differently than normal skin, even with blisters, rarely, after Fraxel.
Many scars do improve within several months and if you wait another month or two you can still obtain a nice result should you choose to have Fraxel then. Keep in mind that one study investigated dermabrasion resurfacing, which is not Fraxel, and showed that the scar obtained a better result at eight weeks than compared with 6 weeks or 3 or 4 months. However, your own body may make it heal better and better so waiting is an option. If you are hesitant, then ask your doctor if they think waiting is OK.

Michael A. Persky, MD · Answer

Hi miss g,
Fraxel is a great laser for the treatment of scars.  You will likely need 3-6 treatments separated by 2-4 weeks.  The end point in my patients is when we both have trouble finding the scar.  Put some socks on so your feet won't be so cold.
Good luck and be well. 
Dr. P

Mehdi Sina, MD · Answer

Hi,
I am happy you were able to get a nice scar revision. Fraxel is a good laser for scars as it helps to break up disorganized collagen in scars. I am not sure it how much it will help with the indentation but if you have a good relationship with your doctor then go for it.
Best,
Mehdi Sina, MD

Jeffrey Weinzweig, MD, FACS · Answer

It is quite common for scars to stay red for some time. Since you just had revision 6 weeks ago I would wait until you get laser treatment done. It is recommended to wait approximately 6 months to give your scar time to heal. Fraxel is an appropriate laser treatment in this case.

Steven Wallach, MD · Answer

6 weeks after a revision is way to early to have to do anything. Usually scars will stay red for a while and settle out, but they usually look there worst at 6 weeks. You may not need anything else but time to allow it to look better. If the scar becomes raised, sure a laser to plane it down like an erbium may be ok. The redness you can treat with an IPL machine.

John P. Di Saia, MD · Answer

Hello, 
You very recently had scar revision. Let the thing heal before you traumatize it again. My opinion is that many of these scars get better with time. You don't need to jump in to more treatment right now. 
This time my opinion is that of dissent.

Bruce K. Barach, MD (retired) · Answer

I have had good luck using fraxel (restore) on scars. one to three treatments has been the usual course. Minimal downside risk so no reason to be nervous about doing this. never forget that the biologic process of scar maturation (and improvement) can go on for a year or more so don't give up on the appearance improving too soon.

What is the Best Laser Treatment for Surgical Scars?

Answers (10)

More Facial Reconstructive Surgery Questions

Wide set eyes: is there any possible way to move them closer cosmetically?

Will an Infraorbital rim implant help my hollow eyes?

Facial asymmetry concerns - what procedures will help to improve this? (Photos)

Titanium plate fitted in 2008. Can my side of head /forehead be given more definition and be more symmetrical? (photo)

What do I need - chin and mandibular angle fillers (possibly chin implant?) and or/rhino? (Photos)

How can I fix this dent in my forehead from an accident? (Photo)

WE SEND PRETTY
EMAILS