Do I need surgical scar revision + expectations? (Photos)

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

Thank you for sharing your story and your journey so far, I can tell how much strength and resilience you’ve had to show after such a significant accident and multiple surgeries. It’s very encouraging that you’re already seeing improvements after your rhinoplasty, and it’s completely natural to want clarity on what the road ahead looks like regarding your scars.

Forehead / Brow Movement
If you’re unable to fully raise your right eyebrow, that does suggest that the frontalis muscle may have been affected during your initial repair. Unfortunately, lasers or surface treatments won’t improve this type of concern if the issue is due to underlying muscle involvement. In these cases, a surgical revision may indeed be required to restore more balanced movement.

Under-Eye Area
For the under-eye region, where the skin is delicate, non-ablative or fractional lasers (such as fractional CO₂ or erbium lasers) are often recommended. These can help smooth irregularities, improve texture, and reduce the visibility of scars while keeping downtime relatively manageable. Sometimes microneedling with radiofrequency can also be beneficial in this area.

Nose Scarring
Since you’ve just had rhinoplasty, it’s wise to give your tissues adequate time to heal before undergoing any aggressive resurfacing. Deep scarring on the nose can respond to ablative CO₂ laser, fractional resurfacing, or even dermabrasion — but these should only be considered once your healing is more complete, usually many months after surgery. In some cases, if scarring is very deep, surgical revision may still be needed later on.

Expectations Over Time
The good news is that scars typically continue to remodel and improve in appearance for up to 12–18 months after an injury or surgery. With a combination of time, the right treatments, and potentially surgical revision if needed, it is realistic to expect that your scars will become far less noticeable and not the defining feature of your face in the years to come.

You’re already taking thoughtful steps by asking the right questions early on. With patience and the right approach, your results can continue to improve significantly.