I had a very old scar it was a result of a compound fracture that occurred 25 years ago. The scar has some indenting and discoloration. I would like to get more volume and remove the 6 pin scars that are deep. What is the best method and around how much can I estimate to pay. Thank you
Can I transfer fat to my lower leg even if there is really no fat in the area? In addition correct the discoloration? (Photo)
Doctor Answers 4
Treating Scar depression and Discoloration
You appear to have 3 different problems, a depression, white scars from the pins and a large area of discoloration from probably hemosiderin deposit from bleeding associated with the fracture. Each requires a different approach. The depression can certainly be treated wit fat grafting. It may take several times because of the scarring. the first graft will improve the surrounding tissues and the blood supply making further grafting more reliable and easier. The only thing that can be done for the white pin tracks is to revise them and try and make the scar smaller and less noticeable. The dark area can be treated with an IPL to lighten it. Lightening it may also make the lighter scars less noticeable. This will probably take several treatments to achieve your desired fading. The cost will be determined by how much fat is needed, how you respond to treatment (whether you need 2 or 3 graft sessions and how many IPL treatments you need) and your decision on what to do.
Fat Transfer and scar revision in the shin area
I am an advocate of fat transfer and have used fat transfer to improve many post traumatic defects. Unfortunately the combination tight, constricted, very poorly vascularized tissue makes any improvement negligible at best. I have not examined all the site of desired scar revsion some may be amenable to conservative scar revision techniques.
Old Scars on Legs/ShinVolume--Lasers (Fraxel, Co2, Erbium), Microneedling/PRP, Subcision, Fillers, Surgery
This needs to be evaluated in person. A combination of lasers, microneedling/PRP and fillers may improve appearance. Please see an expert. Volume can be added with fat transfer and and fillers over time - it will require a number of treatment sessions. Best, Dr. Emer
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Scar revision with fat transfer
In order for fat transfer to be successful the fat has to be grafted into some type of vascular scaffolding or foundation.
In other words the grafted fat has to be placed throughout vascular tissue.
An the area which has skin over muscle or skin over bone will not hold a fat transfer successfully.
In your case I do not believe fat transfer would give a successful outcome.
When attempting to build up volume in areas that lack sufficient tissue to Grafton to fat transfer needs to be done multiple times grafting small amounts each time.
You may be a candidate for scar vision.
And more detailed picture or in person examination it would be needed to see if a scar revision would be justified.
Skin discoloration may be able to be improved with laser treatments.
Another alternative which is cheaper and easier is using silicone sheeting for a few months.
I personally like the brand safetac which is available on Amazon.
Cost for these treatments are going to vary widely depending on what the treatment is, if done in the office or in an operating room and who does the procedure.
A very fair price for a scar division would be $700.
Scar revision with several rounds of fat transfer in an operating room could be well over $5000.
Your scar division it could potentially be covered by medical insurance.
Find a plastic surgeon willing to work with your insurance company.
Understand it that insurance reimbursement will be a small fraction of what our customary fees typically are.
It is highly unlikely Enny insurance company will give any reimbursement for fat transfer.
Mats Hagstrom M.D.
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