How can I treat this scarring from a misaligned incision (from an alarplasty)?

I would suggest try lasering first and at home dermarolling otherwise you need this reconstructed surgically. Best, Dr. Emer.

Keloid scars are characterized by their growth potential and increased degree of inflammation within the skin. Unlike non-inflamed scars, keloids have the potential for growth beyond the original footprint of injury. Our office specializes in the management of keloids, whether single or multiple, using a combination platform that includes lasers, RF, scar modulation, Parke-Davis Scar Protocols, and injection therapy. Some keloids will require surgical intervention as an initial step for treatment.

Massaging your scar can reduce inflammatory mediators that are responsible for chronic inflammation and scar overgrowth. It’s a rather simple technique that inactivates celluar inflammation mechanisms that can lead to keloid and hypertrophic scars. Start by applying a thin coat of Plato's Scar Serum twice daily to the scar and gently massaging the scar footprint. Be gentle, taking care not to slough off newly formed skin and reducing shear force on the dermis. This is ideal for new and old scars.
• Twice daily application of a scar gel.
• Scar modulation with gentle massage.
• Intralesional injections in case there is overgrowth of scar tissue.
• Vascular lasers for neovascularization of scars.
• Stimulatory injections for scar atrophy.
Scar gels work well, but should be combined with a physician-directed protocol to reduce scar formation and reduce scar visibility.

Best,
Dr. Karamanoukian
The Scar Doctor
Realself100 Surgeon