What can I do to smooth the lip lift scar? (Photo)

Question

So I had a lip lift 10 months ago that has been a complete nightmare. I managed to have another doctor/ surgeon give me steroid injections to my lip lift scar . It's looking a lot better but now the texture of the scar is wrinkly and loose. What can I do so smooth and lighten the skin ? I been using silicone sheets and the gels but. I also already had a few vbeam laser treatments. What's next that I can do to improve the scar and tighten the skin?

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 am sorry that this has happened to you, but certainly not surprised. There have been so many similar cases posed by many RealSelf followers. The risks for any invasive cosmetic surgical procedure are for the subsequent development of stretch scars, hypopigmentation and even tram track stitch marks, all of which can be seen here. 
I am also not surprised that they lightbased treatments were ineffective; I have been cautioning my regular followers for years already that the hard science to back up the expensive, "bells and whistles" light and energy-based treatments lags woefully behind the heavy marketing and social media buzz to promote them. What's more, I have seldom found silicone gels and sheets to be of much value and do not recommend them. Once again sorry for the waste of time and money on these things too.
You would be wise to consult with an experienced, board certified cosmetic dermatologist scar treatment specialist regarding the use of professionally performed, manual microneedling (no need for the added expense and risks of RF microneedling) accompanied by the topical application of pigment enhancing medications to improve the surface texture and color of the scar. Hope this helps and best of luck.

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