Atrophic scar treatment after lip lift: What would you recommend?

Question

I have an atrophic surgical scar along my alar wing border down to my nostril as a result of a lip lift. What are the best ways to treat this kind of scar. So far I've been told dermabrasion, CO2 laser (already had fraxel and CO2 laser with little improvement), electrodessication (for scar "webbing'). It looks like the scar margins spread and the scar is indented.

Miguel Mascaro, MD · Answer

Depends on how far out you are from the procedure.  Meaning that if the scar is fairly "fresh" (i.e. surgery within the last 2-3 months) its best to allow it to mature as the collagen found within the scar is continuing to remodel and soften.  During this remodeling stage of healing, you can use vitamin E oil, silicone gels, SPF, etc.  I usually recommend start once daily and after a week or two progress to twice daily.  But again, I'd have to see your scar to figure out whats best, and understand what was done during your procedure.  If you are 6+ months out, then you can talk about resurfacing.  You have already had CO2, so I wouldn't try any laser resurfacing for certainly another few months.  I personally prefer dermabrasion depending on the scar, as I find I can "buff it" a little better.  Not a lot of practitioners do this frequently, but its a great little trick if they are comfortable with it.  I'm not a huge fan of electrodessication - but then again, practitioners who are comfortable with it and get good results may say the same thing about dermabrasion.  Sounds like you have discussed your options with many different docs - this is great.  Its just a matter of picking whom you feel comfortable with and who feels comfortable with treating your scar as well as can give you reasonable expectations based on the previous treatments you have had.  Best of luck! I hope some of this helps.

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

Jed H. Horowitz, MD, FACS · Answer

Hello plainjaneThe incision is placed directly at the base of the nose, following the natural lines so that it becomes nearly invisible with time.

Atrophic scar treatment after lip lift: What would you recommend?

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Atrophic scar treatment after lip lift: What would you recommend?

Answers (3)

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Recommended reading

Everything you need to know about Lip Lift

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