Scar revision or laser for 15 year old scar that is indented and lost pigment?

Question

Scar is 15 years old has lost pigment indented. had a fat injection three weeks ago it looks worse than series of micro needling what can be done to help this

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

Nelson Lee Novick, MD · Answer

Subcision , which I have been performing since 1995, is an excellent, inexpensive, safe and effective technique for elevating and smoothing all kinds of indented (atrophic) scars from all causes, include trauma and previous surgery. Professionally performed manual microneedling, which I have been performing for over twenty-three years, especially when combined with the addition of prescription strength pigment enhancing medications, such as topical tyrosine and lanatoprost, can help to improve both residual superficial texture issues, as well as helping to repigment the hypopigmentation. (Microneedling as a monontherapy for treating scars is not particularly useful, as you unfortunately have found out the hard way. Sorry). You would be wise to consult an experienced, board certified cosmetic dermatologist. A word to the wise going forward: Exercise a great deal of "buyer beware" when being hawked this or that, expensive ,supposedly "next big thing" fraxel laser or RF gizmos with alluring names, as these unfortunately are backed far more by marketing and social media hype than hard science. Hope this helps and best of luck.

Scar revision or laser for 15 year old scar that is indented and lost pigment?

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Scar revision or laser for 15 year old scar that is indented and lost pigment?

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Everything you need to know about Laser Scar Removal

Our mission is to create a world where every investment in modern beauty is Worth It.