Will scar revision surgery lead to better scarring? (Photo)

Question

I had a tummy tuck and breast lift about 3 years ago and have never been content with how my scars matured. I have tried several treatments of Broadband Light Therapy and the results have not been long-lasting or significantly improved the pigmentation of my scars. Would scar removal/revision surgery be a possibility for someone with my type of scar. Clearly I don’t have the best healing skin. I’m a major weight loss patient with a gastric bypass. Thank you!

Nelson Lee Novick, MD · Answer

I'm not at all surprised that the light therapy did not work. The use of so many of those expensive, "bells and whistles" light and energy-based gizmos out there are backed far more by heavy marketing hype and social media buzz than any hard science. From the photos provided there appears to be a very long stretch of an elevated hypertrophic scar.  If this is indeed so, then the use of intralesional injections of an anti-inflamamtory agent in the appropriate concentration and amounts should help to significantly flatten the scar and lighten it to an off-white or ivory color that would blend far better with the surrounding normal skin. Surgical revision surgery, besides the added expense and post-treatment downtime, runs the risk for subsequent development of stretch scars and tram track stitch marks. You would be wise to consult with a board certified cosmetic dermatologist. 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 scar revision surgery lead to better scarring? (Photo)

Answers (2)

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