Scalpel excision of acne scar caused wider scar - Options? (photo)

Question

Hello doctors 1.5 year back i got a excision done for my deep and wide acne scar on my face which failed and has left with more linear wide scar .. a please help me with what topicals and what treatment i can get done to make it better My face is ruined

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'm really sorry that this has happened to you. I have been cautioning my regular followers for years already that surgical revisions (excision) of scars, especially in areas subject to muscular tension or motion, runs the significant risk for the development of stretch scars (as occurred here) and even tram track stitch marks. Once again sorry.
Fortunately, subcision, which I have been performing for thirty years, has a proven track record for safety and efficacy in all skin types for elevating and smoothing all kinds of indented scars, from all causes, including post-surgery (as is the case here).  Once the subcision is performed to achieve the elevation, manual Dermastamp microneedling (no need for the added expense and risks of RF microneedling) can be performed to better blend the treated area-in both color and textyure-with the surrounding normal skin.
You would be wise to consult with a board certified cosmetic dermatologist scar treatment expert. And one more word of caution: exercise a great deal of buyer beware skepticism when you are offered (as you no doubt will be ) treatments with expensive "bells and whistles" fraxel laser and RF treatments, since the hard science to back of the use of these gizmos lags well behind the heavy marketing hype and social media buzz to promote them. Hope this helps and best of luck.

Anna Chacon, MD, FAAD · Answer

I'm sorry to hear about your experience. Addressing a widened scar following a scalpel excision can be challenging, but there are several treatment options that may help improve the appearance of your scar. Here are some potential approaches:

Topical Treatments:

Silicone Gel or Sheets: These can help flatten and soften scars over time. Consistent use is key for best results.
Scar Creams: Products containing ingredients like vitamin E, hydroquinone, or retinoids may help improve scar texture and pigmentation.
Laser Therapy:

Fractional Laser Resurfacing: This can help improve the texture and appearance of scars by promoting collagen production.
Pulsed Dye Laser: Effective for reducing redness and improving the overall appearance of scars.
Microneedling: This procedure can stimulate collagen production and improve the texture and appearance of scars.

Steroid Injections: If the scar is raised, steroid injections can help flatten it.

Scar Revision Surgery: In some cases, a surgical approach to revise the scar may be recommended. This can involve re-excision or techniques like Z-plasty to improve the scar's appearance.

Chemical Peels: These can help improve skin texture by removing the top layers of skin and promoting new skin growth.

Dermabrasion: This mechanical exfoliation technique can help smooth the skin and reduce the appearance of scars.

It's important to consult with a board-certified dermatologist or plastic surgeon who can assess your scar and recommend the most appropriate treatment plan based on your specific situation. They will guide you through the options and help you choose the best approach for improving your scar's appearance.

Scalpel excision of acne scar caused wider scar - Options? (photo)

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Scalpel excision of acne scar caused wider scar - Options? (photo)

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Everything you need to know about Scar Removal

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