What is the best scar treatment option (non surgical)? (Photo)

Question

I’ve consulted several doctors and nurses and have been offered several treatments from co2, to vbeam to other lasers. I have scars from a 360 tummy tuck and thigh lift. Parts are raised but my main concern is the redness- what is my best option - a single procedure or a combination?

Anil R. Shah, MD · Answer

Hello, nmp9292! I'm Landry - a licensed medical aesthetician at Shah Facial Plastics/Aesthetic Skin Chicago and Winnetka, IL. I'm here to help with ideas in treatment for scar treatments for a better outcome.

Lets break down the two different laser treatments you have going on. First Vbeam - the wavelength used is 595nm which targets vascular lesions such as spider veins and hypertrophic scarring as shown above. CO2 lasers are effective at resurfacing the skin by vaporizing particles of our skin. From there, these microchannels boost collagen allowing for a more even skin texture.

If main concern is redness, I'd choose Vbeam. However, for flattening out and pigmentation of the surgery scar, both Vbeam and a CO2 laser would be your best bet.

Nick Slenkovich, MD · Answer

Hello! I’m Lauren, the aesthetic provider here at Colorado Plastic Surgery Center. For scars with both redness and raised areas, a combination approach usually gives the best results. CO2 laser is great for smoothing texture and flattening raised scars, and microneedling helps stimulate deeper collagen remodeling and can improve overall tone. Since your main concern is redness, you might also look in to adding a vascular laser like Vbeam at some point. Most providers will space these treatments out for safety and best healing, but treating them with the CO2 laser and then microneedling, in stages, often leads to more complete and lasting improvement than relying on just one treatment alone.

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

Thank you for sharing your concern and photo. I can see that the redness and raised areas are your main focus, which is very common after procedures like a tummy tuck and thigh lift.

For scars like yours, the best improvement usually comes from a combination of treatments rather than just one. The VBeam laser works beautifully for reducing redness and calming inflammation, while a fractional CO₂ or Er:YAG laser can smooth and soften the texture of the scars over time.

You can also support healing at home with silicone gel or silicone sheets, which help flatten and lighten scars when used consistently. If any areas stay a bit thicker, mild steroid injections can sometimes help reduce that.

In most cases, combining VBeam for color and fractional laser for texture gives the best, most natural-looking results. Scars tend to fade gradually, so patience and consistent care really make a difference. And as always, protect the area from the sun — it helps prevent the redness from lingering.

Nelson Lee Novick, MD · Answer

The elevated portions of the scars can be flattened with intralesional injections of an anti-inflammatory agent, such as triamcinolone. Once the entire scar is flattened,  manual mechanical microneedling can be performed accompanied by the application of Rx topical anti-redness topicals to help to better blend the scar in both color and texture with the surrounding normal skin. Several treatment sessions are typically needed to achieve optimal results. 
A hefty amount of caution is in order when considering the use of so many expensive "bells and whistles" light and energy-based gizmos as the hard science to back up their use lags well behind the heavy marketing hype and social media buzz to promote them. 
Hope this helps and best of luck.

Darryl J. Blinski, MD · Answer

From the post photos, it appears you have a hypertrophic type scar which could be related to the type of closure performed, and type of suture use? Best of virtual consult with for more details to be given. My recommendation would be surgical scar revision using specialized, suture techniques, and suture material to improve results with postoperative silicon taping. Expect fee for revision to range from 5000 $8000. Best of virtual consult with.

What is the best scar treatment option (non surgical)? (Photo)

Answers (6)

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