6 months since I was badly burnt by a laser leaving deep atrophic discoloured scar on my nasal bridge. Advice? (photos)

Question

Help me. It has been 6 months since I was badly burnt by a laser leaving deep atrophic discoloured scar on my nasal bridge. It's been devastating. What can I do to minimise this? I have had filler- fine lines put in 2 x, but it only seems to stay in place for about a week, before migrating out of the scar, and scar returns. And advice? I feel very desperate.

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

Nelson Lee Novick, MD · Answer

So sorry that this has happened to you. I am no fan of the use of lasers for a variety of reasons, as my regular followers are well aware. 
I literally finished treating a patient with a similar issue between her eyebrows about one-half hour ago. I first performed a subcision to elevate and smooth the indented scar. This will be followed by Dermastamp microneedling (no need for the added expense and risks of RF microneedling) accompanied by the application of topical tyrosine and latanoprost to better blend any residual superficial surface textural and color irregularities with the surrounding normal skin. I have personally been performing subcisions since 1995 and microneedling for about twenty-four years with gratifying results. You would be wise to make sure that you are consulting an experienced, board certified cosmetic dermatologist and best of luck.

6 months since I was badly burnt by a laser leaving deep atrophic discoloured scar on my nasal bridge. Advice? (photos)

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