What is the best treatment for this keloid lip scar? (Photos)

Our Hidef protocols for scar revision can address different types of scars, depending on your scar biometrics and characteristics. Protocols vary in duration based on the severity of your scars. 
Bad scars can manifest in many different ways, including pigmentation, thickening, and depression of atrophic scars. Thick scars are best treated in my practice with IIT, cortisone injections, pressure management, and laser. We recommend daily use of Plato’s Scar Serum to the scars to mediate scar hypertrophy. 
Hyperpigmented scars respond well to Melarase AM and Melarase PM creams. If the area is large, consider Luminase and Exfolase creams for the body. Hyperpigmentation PIH can also be treated with Q switch laser, PICO, chemical peels, and rapid scar exfoliation. PIE erythema scars are best treated with pulsed dye laser. 
Keloid scars are our specialization. We manage small and large keloid scars with excision, IIT, PRP, laser therapy, and scar modulation. Use Plato’s Scar Serum daily. 
Textural scars respond well to nanofractional RF and fractional laser to help improve surface texture. When combined with scar modulation, the results can improve dramatically. The most important variable is for you to choose a plastic surgeon with expertise in laser therapy using Hidef protocols. 
Best, 
Dr. Karamanoukian  Realself100 Surgeon

Sometimes the full scar needs to be surgically revised and this just entails surgically/cutting removing and restitching the scar with or without radiation or steroid injections/5fu. I recommend getting a formal evaluation with a cosmetic dermatologist/plastic surgeon. Pigmentation can be treated using cosmelan peel or lightening creams such as hydroquinone, kojic acid, retinol. Non ablative lasers like fraxel combined with vascular lasers such as excel V, yellow laser, v beam/pulsed dye laser, venus versa IPL also help if you want to try and avoid surgery. Microneedling/prp can be added to the lasers or skin care to help the color, texture and tone. Please see an expert. Best, Dr. Emer.

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  Based on
your photographs, you may benefit from a surgical scar revision.  If you have symptoms of pain or itching, this can be covered by insurance, depending on your insurance provider.  This decision should
be based on a detailed discussion with equal input from both you
and your surgeon.   Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results.   The most
important aspect is to find a surgeon you are comfortable with. I recommend
that you seek consultation with a qualified board-certified plastic surgeon who
can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.  FACS
Harvard-trained plastic surgeon