4 months post-op. My scar looks nice until halfway down and then starts widening. Why is that? Do I have a keloid? (photos)

Sorry to hear about your scars, but they do appear rather thickened in those areas.  It can be referred to a Keloid vs Hypertrophic scars.  The definition is a bit different between the two, but for all intended purposed, you have a thickened scar that will unlikely improve over time.I am not certain about laser treatment and don't know of any laser treatment that can improve the appearance of thickened scaring.Things that we know work for hypertrophic/keloid scaring is steroid injections and silicone treatments.In certain cases, a revision surgery may be needed to remove the old scar and start over.  This would still require scar treatment as soon as possible after the revision to prevent the scar from becoming thickened again.Hope that helps.

Hello, thank you for your question. In general, scarring is a product of genetics. Some people are good scar formers, and others are poorer scar formers.  As scars mature over months to a year, the quality of the scar usually improves.  There is almost always lightening of the scars. There is no one best therapy for scars. Silicone sheets, Mederma, and Biocorneum are reasonable and popular options. I recommend that the scar therapy begin after the scars have healed and there are no open areas.

Hello, Thank you for your questions regarding your arm lift, arm reduction or brachioplasty results.  In my opinion you have a hypertrophic arm lift scar, not a keloid scar.  By definition, a keloid is a scar that outgrows the boundaries of the original scar --like a head of cauliflower.  I don't see this in your arm lift pictures.  Examination of your arm lift scar pictures reveals a thick wide scar, not a scar that outgrows the boundaries.  Every plastic surgery has their own ways of treating scar--that's why its called the art of plastic surgery.  Personally, I would perform the surgical scar revision first, not after 4 laser sessions.  Perhaps, your plastic surgeon is hoping that your arm scar will improve so much that you do not need a surgical arm lift scar revision.  When required, which is rare, I perform arm lift, arm reduction, brachioplasty scar revisions in my office under anesthesia.  I perform these scar revisions one arm at time with about one month between each arm.   I specialize in arm lifts.  If you have any more questions regarding the arm lift, arm reduction, brachioplasty or arm scar revision, please contact my office.  Since your arm lift requires a revision,  please seek an experienced, board certified plastic surgeon with significant experience performing these types of arm lifts. Do your research.  Make sure your chosen plastic surgeon has performed at least 100 arm lifts.  Make sure they have the before and after pictures to prove it.  Carefully examine their before and after pictures and check their reviews on RealSelf.   Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon , Certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, International College of Surgery, and American Board of Metabolic and Bariatric Surgery,  and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)