How can I lighten liposuction hyper pigmentation scars? 4% Hydroquinone isn't working much.

It is fairly common to have some hyperpigmentation (darkening) of liposuction scars - especially if you have darker skin. They are located at the sights of the insertion of the cannulas and should be very small in size. The pigment can last for months but should eventually fade. In addition to the use of hydroquinone, you can try adding tretinoin (retin-a). This can be mixed with the hydroquinone and applied 1-2 times per day. I would also recommend that you keep the scars away from sun as this can cause more pigment deposition. Finally, you could try a laser that helps to decrease pigment. I like to use the Fraxel Dual 1927 wavelength. I will usually do a test on just one of the scars first to see if it will work and also to be sure that it doesn't cause more pigment.

Plastic surgery scars require attention after surgery so that they remain cosmetically-appealing and barely noticeable. In our office, we use a protocol for scars that minimizes their activity in the 6-8 weeks after surgery. If you have late plastic surgery scars, you may also require laser and RF therapy to help reduce the longterm effects of the scarring. Keloids, hypertrophic scars, widened scars, red scars, and hyperpigmented scars all require scar modulation with topical creams followed by lasers and RF therapy. Topical skincare should be directed to a specific need, whether for pigmentation or hypertrophy and our office can guide you through the process to obtain the correct Plato’s Scar cream or Melarase cream for hypertrophy and discoloration. In terms of lasers, we would employ the vbeam laser for redness, Venus Viva RF, PRP microneedling, chemical peels, and Morpheus 8, fractional erbium, or fractional co2. All of these have their individual benefits. Most of all, we recommend you visit a solid plastic surgeon who understands surgical scar revision, laser therapy, and RF therapy for scars.

Best,
Dr. Karamanoukian
Realself100 Surgeon

There are some options for treating hyperpigmentation or persistent redness of scars. Sometimes silicone gel applications really work. Bleaching creams which help the scars fade can cause irritation in some individuals, if this happen to you, try them together with cortisone creams. You can also use just one of the cortisone creams, it is proved to be a good treatment all by itself. Fractional Laser or Intense Pulsed Light, which acts similar to laser - both work very well. It will make sense to try it first on one scar, to make sure it will not cause more pigmentation, as you have darker skin. Use high-grade medical peels, protect your body from sun, and give it more time, the scars will fade with in 12 -18 months.I hope this will help, best regards..

Thank
you for your question. Scars usually fade away after a year.
Hyperpigmentation or persistent redness can be treated with a laser.  Adding retin A or spot chemical peels will also help.
Consult with a Board certified Plastic Surgeon for an examination and
treatment recommendations. Best Wishes

Hyperpigmentation is a byproduct of inflammation in generally subsides with time. Hydroquinone is a mainstay sometimes combined with steroid.