How can I get rid of scars and keloids after robotic myomectomy to remove fibroids? (Photos)

Question

Hello Doctor(s) I had a Robotic Myomectomy to remove 6 Fibroids, which left me with scarring and Keloids. The marks on my stomach has left me feeling unhappy. I wanted to know the best way to remove the Keloids and scaring. Thank you.

Raffy Karamanoukian, MD, FACS · Answer

Keloid scars are characterized by their growth potential and increased degree of inflammation within the skin. Unlike non-inflamed scars, keloids have the potential for growth beyond the original footprint of injury. Our office specializes in the management of keloids, whether single or multiple, using a combination platform that includes lasers, RF, scar modulation, Parke-Davis Scar Protocols, and injection therapy. Some keloids will require surgical intervention as an initial step for treatment.

Massaging your scar can reduce inflammatory mediators that are responsible for chronic inflammation and scar overgrowth. It’s a rather simple technique that inactivates celluar inflammation mechanisms that can lead to keloid and hypertrophic scars. Start by applying a thin coat of Plato's Scar Serum twice daily to the scar and gently massaging the scar footprint. Be gentle, taking care not to slough off newly formed skin and reducing shear force on the dermis. This is ideal for new and old scars. 
•	Twice daily application of a scar gel. 
•	Scar modulation with gentle massage.
•	Intralesional injections in case there is overgrowth of scar tissue.
•	Vascular lasers for neovascularization of scars.
•	Stimulatory injections for scar atrophy. 
Scar gels work well, but should be combined with a physician-directed protocol to reduce scar formation and reduce scar visibility.

Best, 
Dr. Karamanoukian
The Scar Doctor
Realself100 Surgeon

Harold J. Kaplan, MD · Answer

Hello BKALLDAY.  For the scars shown in the photos, it's best to start with steroid injections.  We prefer Kenalog for keloid scars.  This flattens the scars and in the process gives the skin a chance for the discoloration to fade.  There are also options for removing the darkness, but we would inject the steroids first to flatten the scars.

Nelson Lee Novick, MD · Answer

Intralesional injections of anti-inflammatory agents, such as triamcinolone and 5-FU are simplest methods and the ones with a  decades' long history of safety and efficacy for treeating hypertrophic scars and keloids. I have published a medical paper on the subject and have been treating these kinds of scars for over three decades. Injections can soften and even flatten these scars completely flush with the surrounding normal skin, but will not eliminate the flat portion; occasionally, particularly in skin of color there may be some loss of pigmentation following treatment, which may require attention.  Unfortunately, there is no good way to entirely eliminate these kinds of scars. Even surgical excision risks recurrence with even larger scars, but flattening can make a significant aesthetic improvement. Make sure to consult a scar specialist and best of luck.

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