What are my treatment options for ugly knee scar that I got in a car accident? (Photos)

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

From the photos, it appears that the scar here has more than one component. Two areas appear elevated: the entire lower portion and to lesser extent the lower portion of the upper half of the scar. If this is indeed the case, the injection of anti-inflammatory agents should help to flatten these portions. Once this is accomplished, microneedling may be used to help improve the overall surface tone and texture of the skin. A biostimulatory filler may be injected below the residual crepy portions to help smooth these still further. I would suggest caution in considering any light-based therapies, such as lasers, as these may lead to prolonged blotchy pigmentation or even permanent loss of pigmentation. I also have strong reservations regarding revision surgery, since this area is under a great deal of mechanical stress and motion, I have concern for the subsequent development of a stretch scar. Make sure that you consult with a board certified aesthetic physician with experience and expertise in all forms of scar treatment. Best of luck. 

So sorry you had this complication. If at least one year has passed, allowing scarring and swelling has settled down, you should be able to undergo scar revision with possible Z-plasty in the near future. The knee is a tough region for scarring, but improvement should be possible. Be sure to consult with a board certified plastic surgeon.  Good Luck!

Hello and thank you for your question. You may be a candidate for scar revision surgery, depending on the degree of skin laxity around your knee.  The most important aspect is to find a surgeon you are
comfortable with. I recommend that you seek consultation with a qualified
board-certified plastic surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

The knee is one of the most difficult places for scarring as you continually stretch it while engaged in daily activities.  Scar revision can only be undertaken if you have enough skin to mobilize. Serial excision and closure may be an option.  Kenalog injections may soften the scar. Best wishes.