Unhappy with appearance of scar after scar revision, what can I do to correct this? (photos)

Question

I feel like the new scar is too long and now even more hypertrophic than my initial scar. I regret it, I should've kept the original scar and been happy. Is there anything I can do to now fix tho bigger problem on my hand? (This new scar is about a month old).

Nelson Lee Novick, MD · Answer

I'm sorry that this has happened to you, but not surprised. I have been cautioning my regular followers for years that scar revision surgeries are not only expensive, invasive, and involve post-treatment downtime, but not uncommonly lead to the development of stretch marks, tram track stitch marks, and bigger scars--the latter appearing to be the case here. At this point, you would be wise to consult with a board certified cosmetic dermatologist scar treatment specialist to discuss shrinking and flattening the scar via intralesional injections of an anti-inflammatory agent followed by manual (no need for the added expense and risks of RF) microneedling accompanied by the application of Rx prescription pigment enhancers to better blend the color and texture of the scar with the surrounding normal skin. And this time be skeptical if offered this or that supposedly "next big thing" hyped fraxel laser or RF treatment for this problem. . Once again, sorry, and hope this helps.

Raffy Karamanoukian, MD, FACS · Answer

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

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Laura A. Katz, MD · Answer

The morpheus8 radiofrequency microneedling device is pretty amazing at scar reduction.  The device transmits radiofrequency energy at various controlled depths up to 4mm resulting in collagen production, scar filling, skin tightening and muscle contraction.  It is very good for all scars including keloids. The procedure is performed easily as an in office procedure with minimal down time. Here is a helpful link.

Unhappy with appearance of scar after scar revision, what can I do to correct this? (photos)

Answers (3)

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