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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
The appearance of a scar will depend on how the incision was re-approximated, the orientation of the scar with relation to relaxed skin tension lines, the quality of the skin (very sebaceous skin heals less favorably), the degree of sun exposure to name a few variables. As other posters have noted, there is no simple answer without a picture. However, at 1 year, the scar is probably not going to change or improve to any significant degree.
There is no one right answer to your question as there are many different scars related to the type of skin and its texture of the patient undergoing surgery. Some people are prone to darkening of their pigment after surgery and others develop red blood vessels around the scar. Some can get overhealing where collagen of their body continues to be produced and deposited in the scar excessively which produces a raised, sometimes painful, scar which may be a hypertrophic scar or keloid. Some people's scars spread, possibly related to an inborn error of collagen and some become inverted as a groove. The scar may have a different shape depending on the shape, depth and diameter of the wound and its relationship to the location of cosmetic structures such as the lip and jaw. The scar may be a line, curve, zig-zag, L-shaped, T-shaped, S-shaped, Z-shaped, H-shaped and other unusual patterns are needed as well. The scar will usually be red for many months. Ultimately, after about 18 months, the body produces maximum maturity of the scar and in the best scenario, it becomes smoother, flatter, and a thin white line. Unsightly scars can be treated, often by Fraxel laser for resurfacing, massage, dressings, V-beam laser for long-standing redness so contact your doctor if you are unhappy.
The appearance of the scar one year after reconstruction is dependent upon multiple factors. The type of repair that was performed, any complications (e.g. infection, hematoma), your own predisposition towards keloids/hypertrophic scars, etc. etc It's not dependent upon the Mohs surgery as the Mohs surgery creates the smallest wound possible (while giving the highest cure rate). It takes about 6-12 months after reconstyruction to reach the final "result" so if you're still concerned about the appearance of the scar, I would return to the doctor who performed the repair and discuss what your options are.
Scar appearances vary, depending up on the location, type of reconstruction, skin tone, exposure to UV light, and wound care. But in general, as time passes, most scars improve in their appearance.
