Do I need a neck lift revision due to scars? 36 y/o male (photos)

Question

I have a neck lift and liposuction to address a double chin. Generally I am please with the results however the scarring is considerable and I would like to know what options I have. I have now had 3 sessions of vbeam laser and several LED treatments. I have used Scar Therapy Silicon Gel and keloidal cream as prescribed. I have been told I have hypertrophic scarring and have been offered a scar revision by my surgeon. Should I wait and see or consider other options/treatments?

Raffy Karamanoukian, MD, FACS · Answer

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Jason Emer, MD · Answer

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in person or virtual consultation to develop a custom and effective treatment plan.  It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

Brian M. Harmych, MD, FACS · Answer

Thank you for sharing your photos and questions. It appears your issue is due to hypertrophic, or excessive, scarring. Additionally, the incisions might be less visible if they had been placed appropriately within the hairline. In the short term, Vbeam and light based therapies are a reasonable options as the inflammation and hypertrophy need to be under control before additional treatments may be performed.  If performed by the appropriately credentialed surgeon, steroid injection may also be helpful in the short term. Ultimately, you will likely need a revision neck lift, or at least a scar revision, to remove the excess scarring and reposition the incisions closer to the hairline. The most important issue here is to be sure to consult with a board certified facial plastic surgeon or general plastic surgeon that has a lot of experience with neck lift AND dealing with hypertrophic scarring. Best wishes, Dr. Harmych

David M. Kowalczyk, MD, MBA, FACS · Answer

Hello! I can see what you’re referring to with your scarring. It seems like your treatment scheme has been fairly extensive. I would consider injecting steroids such as Kenalog into the scars. I often do this roughly every 3 weeks if reduction in the intensity of the scars is seen until a plateau. IPL may work to lighten the coloration. Morpheus8 could soften the scarring. CO2 laser can be excellent for leveling scars but needs to be done very carefully. Cutting the scars out is an option, but there is a risk of no improvement or even worsened scarring. Hope this helps you!

Do I need a neck lift revision due to scars? 36 y/o male (photos)

Answers (4)

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