Revision of Shave Excision Scar? (Photo)

Question

I have a shave excision scar from a mole removal more than 10 years ago on my temple. I am wondering what the best techniques would be for revision of this scar? Laser? If so, which one? Microneedling? Bellafill?

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

Nelson Lee Novick, MD · Answer

The scar is indented. So, subcision, which I have been personally performing since 1995, would be an excellent first step for elevating and smoothing the scar. Following this, if still desired, professionally performed Dermastamp manual microneedling, a procedure I have used with gratifying results for over twenty-three years, can be used as a "polishing" step to treat any residual, surface color and/or textural abnormalities and blend the surface of the scar better with the surrounding normal skin. Contrary to what you may have seen on Dr. Instagram regarding lasers, you should be know, in the words of a recent 11/22 article in the peer-reviewed medical journal JDD,  "social media posts are not standardized and carry a high risk of misinformation."  The fact is that the hard science to support, expensive "bells and whistles" lasers lags woefully behind the heavy marketing and social media influencer-promoted hype. So, exercise a great deal of buyer beware when being offered these approaches. Subcision and professional microneedling have each decades' long track records for safety and efficacy. Hope this helps and best of luck.

Revision of Shave Excision Scar? (Photo)

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Revision of Shave Excision Scar? (Photo)

Answers (2)

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