This scar is about 22 years old. Would scar revision or laser scar removal work better for my facial scar? (Photo)
Doctor Answers 4
Would scar revision or laser scar removal work better for my facial scar?
The laser treatment should be started within 6 weeks after the surgical revision.
Four to six treatment will give you the best result.
Laser Treatment of Scars
Thank you for including the photos. The unknown about your scar is why it became noticeable as it healed. As this is unknown it is best to use a conservative approach. Considering this, recommend starting with using a laser to treat a limited portion of the scar and allowing it to heal for months. If it heals well and has an improvement in appearance would then treat additional portions of the scar. It will probably require more than one laser treatment to optimize the appearance.
"Mature" Scars Respond Well To Combined Subcision & Fractional Microneedle Therapy
Subcision is a procedure in which a sterilized needle is inserted, following the administration of local anesthesia, directly beneath a depressed scar (regardless of whether from acne, infection, trauma, or surgery) and used to break up the thick bands of fibrous scar tissue that bind down the surface and create the depression. On a linear scar, such as this, treatment should typically take no more than a few minutes.
Breaking up the abnormal bands of thickened, scar collagen accomplishes two things. First, it allows the surface of the scar to float to the surface. In addition, the tissue fluid that immediately fills the space following treatment contains growth factors and other wound healing substances that promote neocollagenesis, native collagen production, that allows for improvement and elevation of the scars. Between two to four treatments, spaced at six week intervals, are generally required to promote sufficient new collagen to achieve a satisfactory improvement. Since, the collagen produced is one's own, the results of subcision are typically permanent.
Fractional microneedle therapy aka medical microneedling (or dermarolling) works by creating numerous areas of controlled microwounding that set off in turn a cascade of events that result in new, native collagen synthesis, which translates into healthier, thicker skin that improves the appearance of the underlying scars. It is particularly useful for improving the surface tone and texture of skin to enhance blending with the surrounding normal skin. In this case, it would be helpful for improving what appears to be a background of acne scarring.
Unfortunately, to date I have not been impressed with laser success rates nor the actual degree of overall aesthetic improvement with their use. When it comes to lasers, there is an abundance of media hype and a dearth of rigorous scientific support.
Consultation with a board certified aesthetic core physician with extensive experience in scar treatment is essential.