What can I do to improve my alarplasty scarring? (Photo)

Question

I had an alarplasty six months ago and am concerned about the scarring. I consulted with my surgeon, who reassured me that my scarring was normal for this type of procedure. I would like to know whether the scarring is normal and, if not, what I can do about it through surgical means. Thank you.

Raffy Karamanoukian, MD, FACS · Answer

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Nelson Lee Novick, MD · Answer

Any surgery, like any deep wound of the skin, will result in some kind of scar. The hope is always that the scar that results is not terribly visible.  It is for this reason that I caution my regular followers not to jump to cosmetic surgeries, but to consider surgery as a measure of last resort, especially if nonsurgical options are available. At least from the photos, the bumps may represent small hypertrophic scars or areas where the underlying stitches are superficial and triggering the reaction. In either case, following local anesthesia, light electrocautery can be used to flatten  the bumps and intralesional triamcinolone can be injected to minimize their recurrence. You would be wise to consult with a board certified cosmetic dermatologist with scar treatment experience. Hope this helps and best of luck.

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