Scar Excision - a Cautionary Tale

Just wanted to share a couple more photos. Unfortunately, Dr. Shelton's treatment turned a small and relatively unnoticeable scar into a more complicated situation impacting more of my cheek. I wasted a good amount of time listening to Dr. Shelton tell me to let the site heal for up to 18 months; in reality, the issues that were apparent 3 weeks after his surgery are still readily apparent today, and they will be apparent 3 years from now without further intervention. Once I get some free time in my schedule, I will consult with a couple board certified plastic surgeons to find out what - if anything - can be done to repair the issues created by this surgery. If anyone has recommendations of trustworthy and skilled doctors in New York City, I would love to hear from you.

This started as addressing a single 4x6mm crater scar, and this is the impact it has had on my cheek. Raised tissue around the scar, shiny texture, etc. Dr. Shelton says that my scar is "almost imperceptible."

In early 2017, I found Dr. Shelton on Realself and went to him for help improving on an isolated crater scar in the middle of my cheek that was left by another dermatologist’s shave biopsy of a small mole. I am a healthy 32 year old, not prone to poor healing or scarring—this was the only scar of significance on my face and it seemed like something that just didn't belong there. My career involves public speaking and lots of face-to-face meetings, so I didn’t like feeling self-conscious of this depressed scar that could be seen in certain lighting conditions.
Dr. Shelton said he could do a staged excision—two or three mini-surgeries spaced about six weeks apart, $1,000 each—to remove the crater scar in little steps and leave behind a short, linear scar that would blend in better with the contour of my cheek. He said I might need a couple rounds of laser resurfacing afterward. While the other doctors I consulted said surgical excision was too risky, Dr. Shelton presented the staged excision as a comparatively less risky, creative alternative with “very, very low” chances of making things worse. I asked lots of questions and researched to the best of my ability. I thought his approach was smart and worth a try.
The first stage of surgery went great; the scar's size was reduced by about 50% and the incision site was barely visible at the two-week mark. After surgery, Dr. Shelton commented that he found some deeper scar tissue, but he would just remove it during the next stage.
At the second stage a few weeks later, I joked with Dr. Shelton’s nurse that I might not even need the surgery because the first stage had such a gratifying result. Hearing no apprehension from Dr. Shelton, I went ahead with the procedure. Immediately after surgery, Dr. Shelton said that he found deeper scar tissue than expected and he “did the best he could” to align the tissue layers, but "we’ll have to wait and see" how I heal - the scar could end up looking indented, and maybe surgery isn’t the right approach for me after all (!?!). Upon hearing these unsettling comments, I left his office freshly bandaged up and already feeling that the surgery had failed.
Sure enough, my incision spread apart within a few weeks—first just the superficial layers. When I showed Dr. Shelton, he said we would need to wait three weeks and then “re-do” my surgery, and in the meantime I could keep the incision uncovered--but take an oral antibiotic starting a couple days before the next surgery. By the time the “re-do" day came, the deeper layers of the incision had fully come apart, so Dr. Shelton then had me wear a wound dressing on my face for several weeks to allow the area to heal.
I went in for the third surgery to repair the wound and found out I would need a bigger incision than expected. This was a serious, lengthy surgery—I recall it being over an hour. I had to limit facial expressions for two to three weeks afterward to minimize tension on the incision. I was afraid to smile or laugh for months. This surgery led to intense swelling and a longer scar than anticipated, unusual elevation and textural issues on the surrounding cheek, and tough scar tissue.
For the next 17 months post-surgery, Dr. Shelton guided me through treatments that would hopefully improve my final scar - various laser resurfacings (2x Fraxel, 3x Halo), a steroid injection, even a tiny skin graft from the back of my ear. This involved weeks of swelling, redness, wearing steristrips on my face, avoiding the sun, and 20+ visits to his office in total.
After all of this, I still have a raised, bunched-up area above my scar that looks unnatural, which Dr. Shelton now says is not the result of tissue rearrangement during surgery and is part of my natural facial contour (I should try lymphatic massage and/or steroid injections). I also have flattened, shiny texture around the scar. In some lighting, this mix of features is visible in casual photos from 10+ feet away.
Attached you can see photos of my face before starting treatment, during treatment, and more recently. Dr. Shelton provided free treatment after my surgical complication and he has been consistently kind, compassionate, and responsive, but this has been a notably bad, blindsiding experience that went way outside the bounds of what I thought I was signing up for.
I believe it’s important to share this story for other people considering excision of a relatively small scar in a highly visible location. Please proceed cautiously. And physicians: you understand the complexities and risks of different procedures better than patients do, so we count on you to advise us on appropriate treatment. Don’t let someone who’s looking for help with an isolated cosmetic issue walk themselves into a situation like this one.