Hypertrophic Nose Scars (interested in flap surgery) - will any lasers help? (Photos)

Question

I'm seeking help for hypertrophic/papular acne scars on my nose. This issue has persisted for 11 years, causing insecurity and depression. I've tried: • 2 CO2 + mixto laser treatments • 1 hyfrecation treatment (caused additional scarring) • 5 months of Accutane (and currently still on it for the next 7 months) I'm considering flap surgery. Even though it is drastic, I do not believe any sort of laser treatments work. If you know of any lasers that do help, let me know.

Raffy Karamanoukian, MD, FACS · Answer

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented  scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve  the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture.  Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.
 
Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Nelson Lee Novick, MD · Answer

I have been treating papular acne scars for many years with gratifying results--long before it even got its relatively recent appellation. Papular acne scar bumps most typically appear on the chin and/or nose, as in this case. 
Since papular acne scars are essentially small hypertrophic scars, I usually suggest three test areas to be performed in order to assess the best approach to treatment for any particular patient. These include the use of anti-inflammatory intralesional injections to shrink them; Scalpel Sculpting to contour them to the surrounding normal skin; and low intensity electrocautery to flatten them. In most cases, the latter turns out to be the most common and quickest path taken. 
One or more treatment sessions are typically required to achieve the desired improvement. You would be wise to consult with an experienced, board certified cosmetic dermatologist scar treatment specialist. Hope this helps and best of luck

Hypertrophic Nose Scars (interested in flap surgery) - will any lasers help? (Photos)

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Hypertrophic Nose Scars (interested in flap surgery) - will any lasers help? (Photos)

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Everything you need to know about Scar Removal Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.