How to get rid of deep self-harm scars and find an understanding doctor experienced in this?

Hello and thank you for your question. I commonly perform scar revision surgeries on patients with your exact same story.  Don't be discouraged with your experience with the plastic surgeon you saw.  Find someone else in your area.  The most important aspect is to find a surgeon you are comfortable with. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.Best wishes and good luck.Richard G. Reish, M.D.Harvard-trained plastic surgeon

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best,
Dr. Karamanoukian
Realself100 Surgeon

These may require surgery, lasers, microneedling/PRP or may have no options.  Please see an experienced laser and scarring expert.  Best, Dr. Emer.

First, I'm so sorry you went to a plastic surgeon (and physician) who became uncomfortable with how you got your scars. There is really no excuse for a doctor who doesn't understand what self harm is, and who can't provide good counsel and a compassionate attitude for it. If you can't find that in medicine, we are missing our calling. I went into Plastic Surgery to help heal scars that come with trauma. For me, it was a terrible car accident that would have been truly disfiguring, were it not for the plastic surgeons who operated on me. Even without that experience, I believe I would still be human enough, kind enough, and (frankly) clinically knowledgeable enough to understand that many of the scars my patients have come from difficult experiences, and are not uncommonly self-inflicted. Next, I wanted to acknowledge where you are now, and that you have come from a place where your pain was translated to self-harm, to a place where you want to remove those scars.As far as how to fade the scars, it sounds like scar revision has helped (those must have been deeper, and again I'm sorry you went through that.) For the remaining white, thin, textured scars, probably the best option is laser. Regarding laser:-CO2 laser, or possibly a Fraxel (with proper settings) -call plastic surgery offices, ask what kind of lasers they have, and whether they are targeted for scar removal.To be honest, I can't promise that the laser will make a significant difference on old, fine scars. Much of what laser does has to do with how collagen forms in the scar, and often if it is already fine and white, your body's healing has done more work than a laser can do. Still, addressing the texture may be possible, and you never know until you try. What I would definitely offer you is kindness and encouragement, and the knowledge that you are accepted, scars and all. Best of luck, and I am glad you are in a healing place.