Why are my scars not suitable for surgical scar revision? (photo)

Question

These are the resultant scars from leg lengthening surgery nearly 2 years ago. After 2 consultations one doctor preferred laser and the other didn't think laser would help recommending hydroquinone/retinol/glycolic acid instead. Under normal circumstances my wounds heal very well (my other scars have no discoloration). But due to the nature of this surgery, the wounds were exposed for a long period of time and the scars turned out to be very dark. It's only the discoloration that bothers me.

Harold J. Kaplan, MD · Answer

Hi Rodeogirl.  We would not recommend surgical revision either.  Because the texture of the scars is not the issue, you are very likely so have a similar problem with color if you do a surgical revision.  We would use q-switched lasers to fade the marks.  While we like hydroquinone in many cases, we don't find it all that effective in cases where the dark colored scars also have a had fibrous tissue component to them as well.  In other words, in situations where the dark color is bound up or intertwined with hard scar tissue, we have not found that hydroquinone works effectively.What does help is q-switched lasers.  The reason being that light from this laser (which is designed for tattoos, birthmarks, sun spots and other dark pigment) can easily penetrate the skin, where the HQ cannot.  The laser heats up the pigmented cells, dispersing the color and decreasing the dark color of the scar.  You can see results of treatments for dark scars like this at the link below.  If you decide to go this route, DO NOT choose a practitioner using an IPL and also similarly do not choose a practitioner that has a q-switched laser unless they are experienced in using it to treat dark scars (ask for before and after photos).  Good luck.

Raffy Karamanoukian, MD, FACS · Answer

Scar revision with pulsed dye laser can improve scars on the legs, including these red scars. Raffy Karamanoukian Los Angeles

Darryl J. Blinski, MD · Answer

Over the internet very hard to advise. But why not try one small area as a test scar revision. Thus you could see at s 6 weeks post revision if your healing is acceptable..

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Why are my scars not suitable for surgical scar revision? (photo)

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