Deep MRSA Scar Treatment. Anything else to be done? (Photo)

Question

Been apx a year since a surgeon (to shave my chin bone intraorally) infected me with MRSA. Done 5 fraxel treatments & microneedling with PRP once & ultherapy. I’m thinking this is the end scar even after all that. Very sad as it affects my work on camera. It can look bigger depending on the light. Anything else to be done? When I wear a thick silicone patch overnight it looks better for a few hours since it pulls the indented part up. But is that making it worse over all?

Jeffrey H. Spiegel, MD · Answer

At this point I would recommend scar revision. That would involve removing the scar and sewing it back together with a geometric broken line closure so that it will fade and be loss noticeable over time.  It's done in the office.

Otto Joseph Placik, MD · Answer

Hello, thank you for your question, hard to tell with photos. I welcome you to book a consultation so we can provide you a full and thorough assessment. 
Thank you and good luck!!

Nelson Lee Novick, MD · Answer

I'm really sorry this has happened to you. I'm not surprised by the lack of significant improvement with fraxels and ultherapy and PRP. I have been writing for years that these heavily hyped and heavily promoted "bells and whistles"  still lack the hard science to really back up the hype. And microneedling is best reserved for improving surface, superficial texture and color irregularities and not for deeply indented scars. Subcision +/-filler has a proven track record of over a quarter of a century for elevating and smoothing all kinds of indented (depressed, atrophic) scars.  Revision surgery, especially in areas subject to great deal of tension or movement is prone to the development of stretch scars and stitch track marks. Once the subcision has optimally elevated and smoothed the scar, then microneedling can be used to better blend the treated area with the surrounding normal skin. Make sure to consult with a board certified cosmetic dermatologist or other core aesthetic physician with experience in scar treatments. Make sure to ask to see his/her personal befores and afters. Best of luck.

Mallappa Kolar, MB ChB, BSc, MD, PhD, FRCS (Plast) · Answer

It is unfortunate that you have suffered as you described. The reason the silicone works is that it helps to retain moisture. What that tells me is that increasing volume in the are would help. I would suggest that based on your description and the photos (In person examination would be ideal!) fat grafting the scar would be beneficial.

Reuel Aspacio, MD, FAAD - Account Suspended · Answer

Thank you for your question and photograph.
It's difficult to evaluate your skin through this type of forum, but from what I can, it looks like you have atrophic scarring. This type of scarring is amenable to treatments that injure the skin with subsequent collagen formation, such as fractionated laser, dermaroller, resurfacing lasers, deep peels, etc., may help your condition.  Fillers are a good option, specifically Bellafill®, a permanent filler. Bellafil® is FDA approved in treating acne scars. The right modality for you depends on your skin type, expectations, patience, downtime, and cost. I highly recommend you consult with a board certified dermatologist or plastic surgeon to have your skin evaluated and to discuss treatment options that are appropriate. Take care and good luck.

Deep MRSA Scar Treatment. Anything else to be done? (Photo)

Answers (5)

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