Lip lift scar - should I consider revision surgery to fix this? (Photo)

Subcision, which I have been performing since 1995, is an excellent and simple method for breaking up scar tethering and elevating and smoothing indented scars from all causes, including those following surgery, and in all skin types. Manually performed professionally performed microneedling (no need for the added expense and risks of RF microneedling) can then be used to treat the residual superficial, surface textural irregularities. Surgical revision runs the risk for the subsequent development of a stretch scar and even tram track stitch marks. As so many venues out there are hawking this or that expensive laser or other gizmo for just about anything, you would be wise to make sure to consult with an experienced, board certified cosmetic dermatologist experienced in both subcision and manual microneedling.. Best of luck.

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

For the redness, the best treatment is Sciton BroadBand Light (BBL) specifically targeting the red color (versus the other colors it can target such as brown). Topical treatments such as ZO advanced rozatrol serum and/or Alastin Alluminate (with tranexamic acid) could also help reduce the color, but will not achieve the same degree of improvement you would see with BBL. To soften and improve the scar itself, a series of 2-4 laser treatments can be helpful especially when combined with massaging a steroid such as kenalog and/or 5-fluorouracil onto the area just after fractionated laser treatment. Another great option to consider is nanofat injection which helps the body heal using your own stem cells. Surgical scar revision would be an option, but there is still the risk it could heal in an undesirable way.