Scar treatment options after shoulder lipoma removal and hip liposuction? (Photos)

Question

I have a scar on my shoulder from the removal of a lipoma that is about 1.5 years old. This has some bumps on it (I believe these are keloids) even after running a Halo treatment over it. I also have small scars on my hips from liposuction that are about 4 months old. I've been using BioCorneum cream on them daily since the surgery. Each of these scars bother me and I want to know what the best options are for minimizing their appearance.

Nelson Lee Novick, MD · Answer

From the photos, there appear to be simple, nonsurgical approaches to each of your problems that have stood the tests of time for efficacy and safety. The keloid scars can be flattened via the use of intralesional injections of triamcinolone+/-5-FU in varying amounts and concentrations, and the indented surgical scars can be elevated and smoothed via subcision. Treating keloids, as described above, has a proven track record of over five decades, and subcision over three decades, and these records stand opposed to more faddish treatments with lasers or other relatively expensive "bells and whistles" devices whose hard science to support their use lags well behind the heavy marketing hype to promote them. So, unfortunately, no surprise that the Halo was not successful. Likewise, creams are unlikely to be helpful. Make sure to consult an experienced, board certified cosmetic dermatologist. Best of luck.

Raffy Karamanoukian, MD, FACS · Answer

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

Jason Emer, MD · Answer

It's difficult to determine the best solution for you without the benefit of a formal evaluation. Generally speaking, scars can be improved with a combination of surgery and/or lasers and microneedling with PRP. Below is a more detailed reference list of the treatments available. I recommend getting a formal evaluation with a scarring expert to determine which is best for your specific case. 
Options can include:
1. Vascular lasers (BBL, Yellow laser, V-Beam, Excel V) 
2. Fractional lasers (Fraxel, Erbium, CO2, Halo) 
3. Microneedling/PRP 
4. Silicone-based scar gels with growth factors 
5. Excision/revision surgery 
See an expert to develop a treatment plan that works for you. Best, Dr. Emer​

Daniel Barrett, MD · Answer

Dear tyty82,
it is hard to tell for sure without an examination. If you are considering surgery or treatment, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Scar treatment options after shoulder lipoma removal and hip liposuction? (Photos)

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Scar treatment options after shoulder lipoma removal and hip liposuction? (Photos)

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