Botched neck lift 1 year ago left thick hypertrophic scars around ears and depigmenting along hairline. Treatment advice?

Plastic surgery scars require attention after surgery so that they remain cosmetically-appealing and barely noticeable. In our office, we use a protocol for scars that minimizes their activity in the 6-8 weeks after surgery. If you have late plastic surgery scars, you may also require laser and RF therapy to help reduce the longterm effects of the scarring. Keloids, hypertrophic scars, widened scars, red scars, and hyperpigmented scars all require scar modulation with topical creams followed by lasers and RF therapy. Topical skincare should be directed to a specific need, whether for pigmentation or hypertrophy and our office can guide you through the process to obtain the correct Plato’s Scar cream or Melarase cream for hypertrophy and discoloration. In terms of lasers, we would employ the vbeam laser for redness, Venus Viva RF, PRP microneedling, chemical peels, and Morpheus 8, fractional erbium, or fractional co2. All of these have their individual benefits. Most of all, we recommend you visit a solid plastic surgeon who understands surgical scar revision, laser therapy, and RF therapy for scars.

Best,
Dr. Karamanoukian
Realself100 Surgeon

I am sorry to hear about your disappointment with result. Unfortunately without in person evaluation or at least a series of good photos it is impossible to give you good advice.

For what you describing   the surgeon close your face and neck with a lot of tension.  It is important to examine you to determine if you have enough skin to removed the scars with no tension and allow a better ignition line.

Hi Downhillfast,Aside from cutting out the depigmented skin, consider make-up and tattoo.  Aside from these modalities there is no way to re-pigment skin or scar tissue.You’re at risk for hypertrophic scars with an additional procedure, as you’ve already proven to have developed hypertrophic scars with your first procedure.  Cutting out the hypertrophic scars will required adequate undermining of the surrounding skin for a tension-free closure— make sure your surgeon has enough skin to work with.Scar tissue does not have pigment, so realize that anytime you make an incision on the skin and it heals, that fine line will have no pigment.Best wishes,Dr. Jay

You have no photos posted so I can’t really see what’s going on.  Second, hypertrophic scars are not necessarily because of a botched surgery, but can just be a result of your healing and the way your body heals which cannot be predicted. Without pictures, the scars may have been pulled forward and enlarged out of position by the skin healing. That being said, there is a real risk of scar recurrence with another surgery. You will get a better result if you skin loosens more first and your best solution may be to get a repeat lift to excise the scars without tension on closure. A scar revision might work but I will leave that up to your doctor who can examine you. I have no solution for a thin depigmented scar line. Sometimes this might be the way your body heals. While you are waiting for your revision, make sure your surgeon has considered kenalog injections to improve scar appearance. Some doctors also use 5 FU injections. Best of luck with your treatment.

Scar management in a facelift is very important. Hypertrophic scars typically require a scar revision. The revision has to be done in a very meticulous manner to ensure optimal healing. For patients at risk of hypertrophic scarring, it is common to use other adjuncts such as steroid injections or silicone based creams/dressings to minimize it. Depigmented scars are a challenge and sometimes can be improved with dermabrasion. Hope this helps.