Facelift hypertrophic scars behind ears 6 month post-op? (Photos)

Question

I've been seen by PS monthly . I had 1 injection for hypertrophic scars . Revision in office was discussed , Cuttently checking monthly . Can this be done in office . I've read wait a year . Please advise . Thank you

Brock Ridenour, MD · Answer

I agree with the experts that have answered before me.  These scars do not appear hypertrophic and should heal favorably over time. If they are perhaps more thickened and raised then they appear in the photographs, I  would treat with monthly injections of Kenalog/5FU.  However, it is the vascular nature of the scars that is really the issue. I would treat them with a PDL such as Vbeam, or with any IPL device. One or two treatments should make them indiscernible. Good Luck

Anil R. Shah, MD · Answer

Postauricular scars are commonly seen as red and can be hypertrophic.  Treatment of scars depends on the type of scars seen and can include the following treatments:-laser treatments to help both scars and redness of scars -injections of kenalog or a combination of kenalog and 5-FU -scar revision if poorly positioned scarThe key to great scars after a facelift is to avoid tension on the skin and lift the deeper layer of the face.  Placing too much tension on the skin can make scars wider than ideal.  Meticulous closure technique can also aid in scar appearance.

Brian K. Machida, MD, FACS · Answer

Your scars do not appear to be hypertrophic but show hyperemia.  I don't see any benefit from a surgical revision at this point.  Time will decrease the color, but if you revise it, the exact same phenomenon could occur after the revision.  Lasers might help.  If your scars were hypertrophic, a scar revision in the office is reasonable.

John J. Martin, Jr., MD · Answer

These scars don't appear to be hypertrophic.  They look like they are still healing, and are red - but minimally thick or raised.  They should continue to heal, and with injections can usually be taken care of.  The injections themselves can produce some of the redness which can then be treated with Intense Pulsed light.  If the scar feels a little irregular there are other lasers which can help.  A silicone scar cream such as biocorneum can also help with the scar.

Parker A. Velargo, MD, FACS · Answer

I'm sorry you are experiencing this, but with time and the treatment that your plastic surgeon is giving you, you will likely have a great outcome down the line. Your scars are still pink indicating that they have not fully matured yet. It takes a year or so before that happens. In the interim, like your surgeon, I like to treat these types of scars with an injection combination of kenalog (steroid) and 5-FU monthly. If the scars are still hypertrophic or unsightly after the injections and they have matured, an in-office revision under local anesthesia is perfectly reasonable. It sounds like your plastic surgeon is doing the right things. Good luck to you!

Michael I. Echavez, MD · Answer

Hypertrophic scars after a facelift can sometimes be improved with injection of a steroid, as it sounds that you've had.  Scars can take up to a year to heal fully, so it probably would be best to wait that time before considering any surgical revision.  In most cases, this type of revision procedure could be done in the office with just local anesthesia.

Manish C. Champaneria, MD · Answer

Thank you for your question.Based on your photographs, you scars are still red and raised, and still maturing. I'd recommend awaiting a full year after your surgery before embarking on a revision. When your scars are more flesh-colored and lighter, is a good indication to when to perform surgery. Great that you have seen your surgeon frequently!

Keith Denkler, MD · Answer

Some laser treatments for the red, dilated capillaries should help a lot.Your plastic surgeon may not have a capillary laser and you may need treatment elsewhere.Revision can be considered in the future, but laser can help now.

Jeffrey Marvel, MD · Answer

I would wait at least a year.  Agree with the steroid injections.  I have had good luck mixing 5-FU with the steroid (50;50).  This gives you a lower dose of steroid and the 5-FU works by a different mechanism in shrinking scars.  In time the redness will completely subside.  If you re-excise the scars I believe they will return with a vengance and be even more noticeable.

Darryl J. Blinski, MD · Answer

In my opinion best treatment is the combination of re excision with the first 3 postop days of SRT (radiation therapy) in office. Fee $8,000.

Facelift hypertrophic scars behind ears 6 month post-op? (Photos)

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