I have an atrophic scar on my nasal bridge due to a mole removal 6 months ago. Is CO2 laser or scar revision surgery best?

Question

I have an atrophic scar on my nose bridge; do to a mole removal 6 months ago. One Dermatologic Surgeon says CO2 laser is the best treatment? The other Dermatologic Surgeon says a Scar revision surgrey best. He will turn the 5 mm atrophic scar into a 7 mm straight line acrossnose bridge using a cut and stitches method. Which is the best? Which will leave the smallest scar. Right now I have a 5 mm whole on nose bridge.

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

Christopher Balgobin, MD · Answer

Hello,
Yes, CO2 laser can help reduce scar but you will need a formal consult for best assessment. You can also consider microneedling.

Alyson Wells, MD, FACS · Answer

Without photos it is a bit difficult to give specific advice.  However, if you have a 5 mm depressed, round scar from a punch biopsy/removal of a mole, then it is more likely a formal scar revision (straight line scar with stitches) would be beneficial.  I think it is likely that it may be longer than 7mm, depending on depth of scar and shape.  It is also sometimes necessary to move on to more complex methods of eradicating and reconstructing a deeper scar on the nose (local flaps or perhaps skin grafting in this location).  CO2 laser is beneficial for improving the fine lines and wrinkles of the skin due to age and sun exposure, and can also help acne scarring.  It is less useful to me and my patients if we are trying to improve the appearance of a nose scar that is the result of a mole removal.  I would recommend seeing a board-certified plastic surgeon in person so that they are able to assess the size of the scar adequately and the state of the tissues.  Best wishes for a terrific result from your revision!

Sameer Bashey, MD · Answer

Without pictures its difficult to give you good feedback. Depending on what type or scar and how it looks, there may be different options to make it look better.

Alex Eshaghian, MD, PhD · Answer

Thank you for your question cjagodzinska. Fractional CO2 laser resurfacing is an
outstanding treatment that can address multiple aspects of aging in a single
treatment. IT is difficult to make an assessment without photographs. However, both surgical scar revision and fractional CO2 laser resurfacing can improve scars. Often times a combination approach offers superior results. Please
consult with a doctor for specific recommendations. Good luck!

I have an atrophic scar on my nasal bridge due to a mole removal 6 months ago. Is CO2 laser or scar revision surgery best?

Answers (5)

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