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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. KaramanoukianRealself100 Surgeon
Subcision is a relatively inexpensive technique for elevating and smoothing depressed, indented scars of all types; it engenders little to no significant downtime and has about a three decade track record of safety and efficacy in all skin types. I have personally been performing it since 1994. Once subcision has optimally elevated the scar, professionally performed microneedling accompanied by the application of tyrosine and prescription-strength pigment enhancers may be used to better blend the treated areas in color and texture with the surrounding normal skin. I would be loath to recommend scar revision, especially in an area subject to a great deal of movement as this might result in a larger stretch scar and even stitch track (tram track) scars. Make sure to consult with a board certified cosmetic dermatologist with scar treatment experience and be sure to ask to see his/her personal before and after photos before agreeing to proceed. Best of luck.
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
You may benefit from having this filled in, from a scar revision, or from skin treatments to raise and improve the skin quality. I do think this area should be able to be improved substantially.