Further skin removal to improve knee lift scar wrinkles? (Photo)

Question

Hello! I have bad wrinkling from a prior knee lift surgery. I've had eleven rounds of micro-needling and laser treatments. I don't have enough lax skin to redo the surgery, but there is some laxity on the interior of my knees. Could a little bit of skin be removed from just the interior knees to help solve the wrinkling? I've also had three Fraxel treatments to try to improve the scars. I've read that the laser treatments only garner a 10-20% improvement, if that. I didn't notice any change

Raffy Karamanoukian, MD, FACS · Answer

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

Anna Chacon, MD, FAAD · Answer

Regarding your condition, it appears that you are experiencing a significant degree of wrinkling following a prior knee lift surgery. You undergone eleven rounds of micro-needling and laser treatments, but the wrinkling issue has not been adequately resolved.

Based on your available skin laxity, specifically on the interior of the knees, there could be a potential solution to consider. However, it is important to note that the removal of skin from just the interior of the knees might not provide a comprehensive solution to the issue.

Given that you have insufficient skin laxity to redo the surgery, a less invasive approach may be beneficial. This could involve targeted treatments such as radiofrequency or ultrasound-based devices, that could help to tighten the skin and reduce the appearance of wrinkles.

Nevertheless, it is essential to carefully evaluate your overall health, the severity of the wrinkling, and the potential risks and benefits before deciding on the best course of action.

A consultation with a dermatologist or a plastic surgeon specialized in skin and soft tissue might also be beneficial. They could provide a more detailed assessment and suggest other potential treatments like injectable fillers or botox that may be more suitable and less invasive for this specific case.

Laura A. Katz, MD · Answer

Hello there.  Thank you for your question.  The morpheus 8 radiofrequency microneedling device would likely work very well for these stretchy skin scar areas.  The morpheus treatment induces collagen production, skin plumping, wrinkle reduction, fills in scars and causes skin tightening as well.  I wthink this would be a great option for you rather than additional laser treatments or more surgery.  This is all done in an office setting as well with visible difference in as soon as a month.

Further skin removal to improve knee lift scar wrinkles? (Photo)

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Further skin removal to improve knee lift scar wrinkles? (Photo)

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