I have a hypertrophic scar on my knees. Is it possible to improve the appearance of my knees? (Photos)

Question

The scar is hyperthropic with discoloration. It is only a little bit raised. I just want to improve the texture to be less visible. What method do you recommend? And on what price range? If you are LA doctor and have offer please contact me.

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

Jason Emer, MD · Answer

Hypertrophic scars can be improved with a combination of Cosmelan, lasers, Aerolase, microneedling/prp, skin lightening, peels, and skin care. Sun protection is essential. I recommend getting a formal evaluation with a scarring expert. Best, Dr. Emer

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  Based on
your photographs, you may benefit from a surgical scar excision with a multi-layered closure.  This decision should
be based on a detailed discussion with equal input from both you
and your surgeon.   Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results.   The most
important aspect is to find a surgeon you are comfortable with. I recommend
that you seek consultation with a qualified board-certified plastic surgeon who
can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.  FACS
Harvard-trained plastic surgeon

David P. Melamed, MD · Answer

This appears to a traumatic scar and it generally responds well to PRP treatments with microneedling in order to rebuild the tissue, and i combination with laser treatments to improve the color.  A special dressing should applied to the area in order to avoid color changes and other complications.  You will likely need 2-3 treatments.

Johnson C. Lee, MD · Answer

Scars continue to mature and improve over a year. You can continue treating your scar with various methods. Topical options include silicone-based strips or gels. Most importantly, keep them out of the sun. Overtime, your scar should continue to improve on its own. For  young,old, or deeper scars that have plateaued in their improvement, microneedling with or without PRP, fractionated laser, and radiofrequency make microscopic holes in the scar to stimulate your body to remodel and fill in the scar with new collagen. I especially like a combination of a chemical peel for the hyperpigmentation and acne control, microneedling with PRP for texture and collagen building, and PIXEL fractionated laser or RF to resurface and build even more collagen.  For large or more severe irregularities, a scar revision or re-excision may swap out your old scar for a less noticeable one in a single procedure. Not everyone is a candidate for all the treatment options however as certain skin types can get worse from certain treatments. For the safest treatment plan, it is important to visit an expert for an in-person examination. Hope this helps!
Johnson C. Lee, MD 
Board-Certified Plastic Surgeon
IG: @drjohnsonlee

I have a hypertrophic scar on my knees. Is it possible to improve the appearance of my knees? (Photos)

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