Scar revision poor closure - is there any way to perform another scar revision? (Photo)

Question

Is there anyway to perform another scar revision where the scar is removed? Originally a chemical burn. Had serial excisions performed horizontally. The width of the bottom part of the scar is what bothers. Is a tissue expander too aggressive for this? Its errythematous, but it looks better this way as I have a ton of red tones to my skin color and when it turns white it will look worse eventually.

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

My concern in this case (and this is my reservation regarding many scar revision surgeries) is that revision surgeries, particularly in regions subject to a great deal of static and/or dynamic muscular tension, run the significant risk for the subsequent development of stretch scars (and even in some cases tram track stitch mars), as apparently happened previously in this case. 
You may wish to consider the use professionally performed, manual microneedling (no need for the added expense or risks of RF microneedling) for helping to better blend in both texture and color the scar with the surrounding normal skin. You would be wise to make sure to consult with an experienced, board certified cosmetic dermatologist scar treatment sessions. You would also be wise to exercise a good deal of "buyer beware" caution if offered treatment any of the expensive, light and energy-based gizmos out there, like fraxel lasers and RF devices, as the hard science to support the use of these "bells and whistles" lags woefully behind the heavy duty marketing hype and social media buzz to hawk them. 
Hope this helps and best of luck.

Scar revision poor closure - is there any way to perform another scar revision? (Photo)

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Scar revision poor closure - is there any way to perform another scar revision? (Photo)

Answers (2)

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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.