Cortisone kenalog injection for scar tissue fibrosis

Question

I have developed really thick internal fibrosis after 2 scar revision on my forehead. The second surgery was meant to remove the fibrosis lump but the it came back bigger and thicker.I had 2 rounds of kenalog10 so far.I ll say ive seen 25%of improvement so far.My question is what can help doctor inject more precisely?Since its internal i feel he missed some parts.Also my lump is really thick and big should i ask for stronger drug? i havent seen any dent so far im asian male and have thick skin.

Jason Emer, MD · Answer

Combination therapy is needed for this.  lasers help remodel the scar and needling helps improve texture as well.  I suggest prp along with 5FU injections to promote more quick healing.  See a scarring expert.  Best, Dr. Emer.

Raffy Karamanoukian, MD, FACS · Answer

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Jaime S. Schwartz, MD, FACS · Answer

I appreciate your question.If you had surgery and internal fibrosis which recurred, it might be time for a second opinion to see whats going onThe best way to assess and give true advice would be an in-person exam.Please see a board-certified plastic surgeon that specializes in aesthetic and restorative plastic surgery.best of luck!Dr Schwartz

Harold J. Kaplan, MD · Answer

Hi Ducks.  As you have identified, the amount and strength of the solution can affect the effectiveness of the injections.  In many cases, MDs will be conservative on the first round of injections as they don't want to fix one problem and cause another (an indentation) because the side effect of injecting too much steroid is that the skin can atrophy and leave a depression.  If you are not achieving the kind of results you want, then consider getting a second opinion.  To see examples of steroid injections for a keloid scar in Los Angeles, click on the link below.

Cortisone kenalog injection for scar tissue fibrosis

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