Breast Augmentation Scar Removal for Darker Skin Tones (photo)

Question

Hello, I have already done 6 laser treatments on my breast augmentation scars. Is there anything that I can do to improve the discoloration?

Raffy Karamanoukian, MD, FACS · Answer

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented  scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve  the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture.  Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.

Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Anna Chacon, MD, FAAD · Answer

Scars on darker skin tones can be more prone to hyperpigmentation or hypopigmentation, making discoloration a common concern even after laser treatments. Since you've already had six laser sessions, you may want to consider additional treatments to further improve discoloration, such as:

Topical Treatments: Prescription creams containing hydroquinone, retinoids, or corticosteroids can help lighten hyperpigmented scars. Silicone gels or sheets can also improve texture and color over time.
Microneedling: This treatment can help break down scar tissue and promote collagen production, improving both texture and pigmentation.
Chemical Peels: Mild to moderate peels, such as those with lactic acid or glycolic acid, can help fade discoloration gradually.
Platelet-Rich Plasma (PRP) Therapy: When combined with microneedling, PRP can accelerate healing and reduce pigmentation issues.
Steroid Injections: If the scar is raised, steroid injections may help flatten it while reducing hyperpigmentation.
It's important to work with a dermatologist experienced in treating darker skin tones to minimize the risk of further pigmentation changes. Sun protection is also crucial, as UV exposure can worsen discoloration.

Nelson Lee Novick, MD · Answer

I'm sorry that you were not satisfied with the laser treatments, but I am certainly not surprised. I have been cautioning my regular followers for years to exercise a whole lot of buyer beware when being hawked so many of the expensive, so-called Light and energy-based treatments, like fraxel lasers, etc, since the hard science to back up their use unfortunately lags well behind the heavy marketing hype and social media buzz to promote them. Sorry. 
You may wish to investigate the use of professionally-performed (not home use), manual, Dermastamp microneedling (no need again here for the added expense and risks of RF microneedling) to help to better blend the texture and color of the scars with the surrounding areas. Dermastamp microneedling, which is able to focus on individual areas, would permit treatment of the hypopigmented accompanied by RX pigment promoting topicals, as well allow for treatment of the hyperpigmented area with RX bleaching topical. 
You would be wise to consult with an experienced, board certified cosmetic dermatologist scar treatment expert and best of luck. .

Earl Stephenson, Jr., MD, DDS, MBA · Answer

Dear FunFoodieLover,

Thank you for your pictures. This is a difficult issue to address people of color. The best non-surgical treatment would be to apply compounded hydrocodone for specific period of time and sunscreen. Laser treatment will prove to be ineffective and produce areas of hypopigmentation. This will be a "labor of love."

Best wishes,

Earl Stephenson, Jr, MD, DDS, MBA,

ESJ Aesthetics

Breast Augmentation Scar Removal for Darker Skin Tones (photo)

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Breast Augmentation Scar Removal for Darker Skin Tones (photo)

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