What is the Best Way to Remove Pigmentation After Laser Mole Removal?

I would recommend that you see a board certified facial plastic surgeon for an evaluation.  I would possibly favor complete surgical excision.  However, with any procedure, you will be trading in the mole for a potential scar.  

Raised moles can be removed in multiple ways. The gold standard these days is RF technology but they can also be removed via Erbium Laser using 2940 wavelength or even Plasma Pen. It sounds as though these were removed using 2940 Laser. If this was the case and the mole has regrown and increased in pigment it is because the mole and pigment is coming from the skin’s dermis. If pigment originates in the dermis of the skin it needs to be removed using a QSwitch 1064 Laser. This will ensure that the wavelength penetrates deep enough into the skin’s dermis to remove the pigment and the QSwitch Pulse will ensure the pigment can be effectively removed by mechanical energy as heat energy does not work on deep dermal pigment. Some moles do require two different treatments to remove them. So a raised mole that originates in the dermis of the skin will require both a QSwitch 1064 Laser and RF Technology. If there is still a raised section on the mole I would recommend removing this with RF Technology.

Lasers are an effective tool for certain skin conditions but should be used selectively and in my opinion mole removal should not be done with a laser.  Mole removal needs to be done surgically to leave the most optimal scar and to evaluate the mole histologically to rule out any abnormalities.

Sometimes pigment returns or intensifies after laser surgery of moles or after moles have been shaved off because not all of the cells that make pigment were removed. For that reason I prefer to remove the moles surgically because I can be certain that pigment will not return and because I will have a pathological record of each mole. So the only way to guarantee removal is by surgical excision and sutured closure. Other options inlcude repeated laser treatments or cryotherapy (liquid nitrogen treatment). Talk to you surgeon, and if you're not satisfied with the options, get a second opinion from a dermatologist.

I feel that it is never appropriate to use a laser as your primary treatment for removing a mole. Regardless of how "benign" a mole may appear, a biopsy may still reveal it to be atypical. Using a laser to improve the appearance of a mole will alter its look and make it more difficult to observe for precancerous changes in the future. The majority of a mole can be removed very easily, and less expensively, using a shave biopsy technique. This typically results in a minimal scar, making the mole much less visible. It also has the added benefit of having tissue to send for microscopic examination, at least for reassurance purposes. The best way to remove the deeper pigmentation that was left behind from your laser treatment would be to do a simple surgical excision of the area with suture closure to give you the best cosmetic result. This should result in a linear scar that will be much less visible.