Will my scars improve with time? Are there procedures that can help minimize their appearance? (photos)

Question

I had an awful surgery which left me with these horrible scars. They have healed properly (i.e. they are not atrophic) but the skin on the edges is bumpy and raised, so the scars appear depressed. They are very visible when I am inside with artificial lights and I feel disfigured. My doctor assured me that they would have been hidden. I was afraid and he insisted and now I look like this. It's been 11 months. I have two questions: - will they continue to improve? - is there any solution?

Nelson Lee Novick, MD · Answer

Unfortunately, it is a bit difficult to assess the scars from the photos provided. However, there are certain basic principles for treating all kinds of scars, including post-surgical scars, as in this case. Number one, the ideal window of time for treating any developing scar is between week eight when the wound is healed sufficiently to withstand treatment and week twelve, after which the scar is considered "mature" and the chances for achieving almost complete erasure are significantly less. When treating scars, if they are depressed (i.e. atrophic, indented), then a procedure, such as subcision can be used to elevate and smooth them. If they are elevated above the surface, then they can be shrunk and flattened by the use of intralesional injections of anti-inflammatory agents and/or scalpel sculpting the of the elevations so that elevated portions flattened and flush with the surrounding normal skin. And finally, if the scar is hypopigmented, as many often are, professionally performed microneedling accompanied by the application of prescription-strength pigment promoting agents, such as topical tyrosine and lanatoprost, can help to better blend the treated scars in both color and texture with the normal background skin. Surgical revision in areas subject to a great deal of skin tension or muscular movement runs the risk for the development of unsightly stretch scars and tram track stitch track marks. Make sure to consult with a board certified cosmetic dermatologist and exercise a healthy dose of buyer beware when offered all kinds of expensive treatments with "bells and whistles" fraxel lasers, RF devices, etc. as the hard science to support their use lags woefully behind the heavy marketing to promote them. Hope this helps and best of luck.

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

Will my scars improve with time? Are there procedures that can help minimize their appearance? (photos)

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Will my scars improve with time? Are there procedures that can help minimize their appearance? (photos)

Answers (2)

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Everything you need to know about Laser Scar Removal

Our mission is to create a world where every investment in modern beauty is Worth It.