Scar removal treatment - post BBL surgery?? (photos)

Question

Visible scars at multiple places on my back. Following my BBL surgery in Dec 2022, I now have two incision scars on the upper part of my back, two scars on either sides of my buttocks (upper corner), and one right above the buttcrack post BBL surgery. What are the potential treatment options to reduce or remove these scars completely?

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

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

Ajaya Kashyap, MD · Answer

Thank you for your query. Based on your photographs fractionated Co2 laser treatments can give you good results. Please discuss your concerns with your surgeon who can help you. All the best!

Nelson Lee Novick, MD · Answer

Unfortunately, from the photos provided it is difficult to precisely determine what kinds of scars are present. However, there are certain general rules that you may find helpful.

For elevated scars, such as hypertrophic or keoid scars, consider intralesional injections of an anti-inflammatory agent, such as triamcinolone to flatten them.

For indented scars, consider subcision to elevate and smooth them with or without the addition of an HA filler (which itself may enhance new collagen production).

For hypopigmented scars, consider professionally performed manual microneedling (no need the added risks and expense of RF microneedling) with addition of Rx topical pigment enhancers, such as tyrosine and latanoprost.

For hyperpigmented scars, consider professionally performed manual microneedling (again no need the added risks and expense of RF microneedling) with addition of Rx topical brightening agents, such as tranexamic or azelaic acid.

In my experience, silicone patches, gels and creams and other extracts have proven of little value and not worth either the expense or time.

And finally, be very cautious when being offered many of the expensive "bells and whistles" fraxel laser or RF treatments, as the hard science to back up their use lags well behind the heavy marketing and social media hype out there to promote them. What's more, aggressive lasers, such as the C02 laser, particularly in skin of color, besides typically engendering significant post-treatment downtime, poses a risk for skin dyspigmentation, particularly in skin of color.

Hope this guide helps and best of luck.

Anna Chacon, MD, FAAD · Answer

For post-surgical scar management, there are several treatment options available that can help reduce the appearance of scars and improve skin texture. Here are some potential treatments to consider:

Topical Treatments:

Silicone Gel or Sheets: These can be applied directly to the scars to help flatten and soften them over time.
Scar Creams: Products containing ingredients like silicone, onion extract, or vitamin E may aid in scar reduction.
Minimally Invasive Procedures:

Laser Therapy: Fractional lasers can improve scar texture and color by promoting collagen production and skin remodeling.
Microneedling: This procedure uses tiny needles to create micro-injuries in the skin, stimulating collagen production and improving scar appearance.
Injectable Treatments:

Steroid Injections: Useful for thick or raised scars (hypertrophic or keloid), these can help flatten and soften the scar tissue.
Filler Injections: In some cases, fillers can help elevate indented scars to align with the surrounding skin.
Surgical Options:

Scar Revision Surgery: For severe scars, a plastic surgeon can remove the old scar and re-close the area with precise techniques to minimize scar formation.
Other Treatments:

Chemical Peels: These can improve skin texture and tone but may not be suitable for all skin types or scar depths.
Massage Therapy: Regular massage of the scar tissue can help break down dense scar tissue and improve flexibility.
Next Steps:

Consult a Dermatologist or Plastic Surgeon: It's important to have a professional evaluation to determine the most appropriate treatment based on the type, location, and severity of your scars.
Customized Treatment Plan: A specialist can create a tailored plan to address your specific scars and aesthetic goals.
Each scar and individual's skin is unique, so treatments may vary in effectiveness. A professional consultation will provide the best guidance for achieving optimal results.

Anil R. Shah, MD · Answer

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin - Winnetka & Chicago. This is a great question. I recommend CO2 laser resurfacing for treating the visible scars on your back following your BBL surgery. CO2 laser is one of the most effective options for improving the appearance of surgical scars because it works by removing the outer layers of damaged skin and stimulating collagen production deep within the skin. This not only helps to smooth and resurface the texture of the scarred areas but also encourages the skin to regenerate more evenly over time. Given the location and number of your scars, CO2 laser can be precisely targeted to each one, helping to soften their appearance, reduce discoloration, and blend them more seamlessly with the surrounding skin. While no treatment can completely erase a scar, CO2 laser resurfacing can significantly improve their visibility and texture, especially when paired with proper aftercare and, if needed, multiple sessions. I hope this helps and best of luck!

Scar removal treatment - post BBL surgery?? (photos)

Answers (5)

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