Options for improving scar line (Photo)

Question

Hello. I had my lip lift surgery a year ago and have been diligent with my doctor's care routine but am unhappy with how it healed. She suggested more steroid injections but I'm afraid it already looks too indented. The corners of the scar also has uneven dimples. After some research I asked about co2 laser treatments but she said it wouldn't work. Would love another opinion on what I can do. Hoping to avoid a scar revision surgery. Thanks!

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

Nelson Lee Novick, MD · Answer

I share your concern regarding revision surgery, which poses a potential risk for the subsequent development of stretch scars and tram track stitch marks, particularly when performed in areas subject to dynamic or static tension.  Professionally performed manual Dermastamp microneedling (no need for the added expense and risks of RF micorneedling) can be helpful for blending the scar better in both texture and color with the surrounding normal skin. If scar hypopigmentation is a particular concern then this may be accompanied by the topical application of prescription strength pigment enhancing agents, such as topical tyrosine and lanatoprost. You would be wise to consult a board certified cosmetic dermatologist. Hope this helps and best of luck.

Viktoryia Kazlouskaya, MD · Answer

I agree that steroids likely won't help. However, I do not see a reason why you shouldn't try resurfacing with CO2 or erbium.

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