Possible to get scar revision on chest with good results if you stay still after and use all modern aftercare products? (Photos)

Question

I have two circular 1.5cm diameter hypertrophic scars on my chest from mole excision when I was 14. I am now 28. Being young I moved a lot while healing so they did not heal well. The surgeon did not use silicone sheets or give me any creams, just stitches. I have the next few months off work and can be immobile while they heal this time, and can use modern scar reduction methods not common 15 years ago. Can I get a better result than just laser removal + hair transplant, taking all precautions?

Raffy Karamanoukian, MD, FACS · Answer

Plastic surgery scars require attention after surgery so that they remain cosmetically-appealing and barely noticeable. In our office, we use a protocol for scars that minimizes their activity in the 6-8 weeks after surgery. If you have late plastic surgery scars, you may also require laser and RF therapy to help reduce the longterm effects of the scarring. Keloids, hypertrophic scars, widened scars, red scars, and hyperpigmented scars all require scar modulation with topical creams followed by lasers and RF therapy. Topical skincare should be directed to a specific need, whether for pigmentation or hypertrophy and our office can guide you through the process to obtain the correct Plato’s Scar cream or Melarase cream for hypertrophy and discoloration. In terms of lasers, we would employ the vbeam laser for redness, Venus Viva RF, PRP microneedling, chemical peels, and Morpheus 8, fractional erbium, or fractional co2. All of these have their individual benefits. Most of all, we recommend you visit a solid plastic surgeon who understands surgical scar revision, laser therapy, and RF therapy for scars. 
 
Best, 
Dr. Karamanoukian
Realself100 Surgeon

Jason Emer, MD · Answer

No need to be immobile with recovery! Hair transplant may work to improve the appearance, but this can also be treated with 5fu/steroid injections and lasers (yellow, pulsed dye, vbeam, fraxel, Co2) if its enlarged. Please see an expert in lasers and scars.   Best, Dr. Emer.

Johnson C. Lee, MD · Answer

Thank you for your photos. Scars continue to mature and improve over a year but don't change much after that. Your scars at this point are unlikely to change on their own. They appear to be flat but with some hyperpigmentation and loss of hair. For these scars, a surgical excision and convert your scar from a round area to a thin line and improve its appearance. You can then optimize this new "replacement" scar with various topical options such as silicone-based strips or gels and most importantly - keep them out of the sun. Other treatments such as microneedling work well but only if necessary as your scar continues to heal. Hair loss is more difficult to treat and if it is still an issue, then you may benefit from hair tranplanation into the scar tissue to help camoflauge the area. For the best treatment options, it is important to visit an expert for an in-person examination. Hope this helps!

Johnson C. Lee MD

Plastic Surgery

Johnson C. Lee MD

Plastic Surgery

Arian Mowlavi, MD, FACS (license on probation) · Answer

You can get a scar revision of your chest scar which will leave you with an incision line that you can optimize healing using silicone sheeting.

Possible to get scar revision on chest with good results if you stay still after and use all modern aftercare products? (Photos)

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