Would this scar benefit from a laser treatment? (photos)

If so, which type (i.e. ablative, fractional ablative, non-ablative, etc)?

I have a scar from a lesion removal by currettage. It's in the middle of my cheek and I hate it. People tell me it's not that bad and that I should get over it but I can't. Would a laser help to blend the scar in more? If so, what kind of laser do you recommend? Is it realistic to expect to get the scar level with the surrounding skin? One PS recommended a spot (mechanical) dermabrasion but I am concerned about the risk of hypopigmentation. Thank you.

Doctor Answers 1

Subcision Works Well For Permanently Elevating Depressed Scars.

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Unfortunately, to date I have not been impressed with laser success rates nor the actual degree of overall aesthetic improvement with their use. When it comes to lasers, there is an abundance of media hype and a dearth of rigorous scientific support.  

On the other hand, subcision can be effective for permanently elevating depressed scars of various types, including acne, chicken pox, traumatic and surgical scars. Subcision is a procedure in which a sterilized needle is inserted, following the administration of local anesthesia, directly beneath a depressed scar (regardless of whether from acne, infection, trauma, or surgery) and used to break up the thick bands of fibrous scar tissue that bind down the surface and create the depression.

Breaking up the abnormal bands of thickened, scar collagen accomplishes two things. First, it allows the surface of the scar to float to the surface. In addition, the tissue fluid that immediately fills the space following treatment contains growth factors and other wound healing substances that promote neocollagenesis, native collagen production, that allows for improvement and elevation of the scars. Between two to four treatments, spaced at six week intervals, are generally required to promote sufficient new collagen to achieve a satisfactory improvement. Since, the collagen produced is one's own, the results of subcision are typically permanent.

Fractional microneedle therapy aka medical microneedling works by creating numerous areas of controlled microwounding that set off in turn a cascade of events that result in new, native collagen synthesis, which translates into healthier, thicker skin that improves the appearance of the underlying scars. It is particularly useful for improving the surface tone and texture of skin to enhance blending with the surrounding normal skin. A Dermastamp is a small punch-like device that can be used for medical microneedling small areas, such as the ones shown in the photos.

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