Question: Is it possible to get rid of keloid scars? How do you prevent them from occurring again?
Answer: Keloid scars can be a very difficult thing to completely get rid of, but if your keloid is relatively new we can consider injections of steroid into the keloid to make it shrink, but if it has been present for an extended period of time then we would have to surgically resect the keloid and then start over following the area very closely so that steroid injections can be placed at the very earliest sign of keloid recurrence in hopes of preventing it from coming back. Even with this regimen, there is still a significant risk of a keloid recurring, and I always discuss with my keloid patients that there is actually a risk of making the keloid worse than it started though I have not personally seen this actually happen in anybody it, nonetheless, is a very small risk.
Question: How long should a scar mature before performing scar revision?
Answer: The answer to that question really depends on the person’s age as children can have immature scars for years and many will take until they go through puberty before the scar matures, whereas in adults it is usually six to twelve months and the scar is essentially mature.
Question: Can laser skin resurfacing remove birthmarks?
Answer: Most birthmarks are not able to be removed with laser skin resurfacing but certainly some are. It really depends on the type of birthmark, the amount of pigmentation, and the depth of the pigmentation as to whether or not this would be improved with laser skin resurfacing, and frequently we really do not know until we try to remove these with laser skin resurfacing, and frequently we are successful and yet other times we are not.
Question: My daughter is 20 and had problems with acne that have finally subsided leaving her with scars. Can fat injections help to smooth out the scars from adolescent acne problems?
Answer: Fat injections can definitely improve upon acne scarring but is certainly not going to be 100% effective and requires experienced hands to not only place fat into this area but also to lyse or cut the scar tissue beneath the acne scarring in a very precise and consistent manner. Depending on your daughter’s actual appearance of the acne scarring, I may or may not recommend laser treatments for a better result in my hands.
Question: I have chickenpox scars on my face from when I was six years old. I am now 30. Is there any kind of chemical peel that would work now or is it too late?
Answer: For the most part, chemical peels are really not the best option for chickenpox scars though, theoretically, a very deep chemical peel could certainly improve their appearance. I personally am partial to the ProFractional Laser by Sciton as the fractionated Erbium laser treatments spaced a month apart for about three treatments can do a wonderful job of improving textural and surface irregularities due to problems such as chickenpox scars, traumatic scars, surgical scars, and acne scarring.
Question: I had dog bite when I was a child. The scars are still visible. What procedure do you use for scar revision? Can this be done in the office?
Answer: The nature and depth of the scar will determine what modality I would recommend regarding treatment of it. Frequently, scar revisions can be easily performed in the office setting using local anesthesia and in other circumstances scars are amenable to advanced laser treatments such as the Profractional Laser by Sciton, which can greatly reduce the visual appearance of these scars. Ultimately, a consultation with a board certified facial plastic surgeon would be appropriate so that you ultimately get the result you desire.
Question: I would like to get a large scar taken off of my forehead that I have had since a childhood accident. I have been embarrassed and self-conscious about its appearance for years, and I am finally ready to get it removed. Will a scar revision procedure completely eliminate its appearance?
Answer: Scar revision surgery cannot eliminate a scar. It only trades off a new more aesthetically appropriate scar for the more noticeable scar that existed there. I certainly have had patients where a scar revision in association with other more advanced treatments such as Profractional laser resurfacing can make the scar almost invisible but, nonetheless, there still is a scar present since there has been a prior injury to that tissue. So, patients need to understand that we cannot completely eliminate scars, but we merely are trying to reduce the visibility of the scar and make it much less noticeable.
Question: I have a scar on my cheek from being bit as a child. It has always bothered me, and I would like to see if there is some way that I can get rid of it or at least improve it. I have heard of scar revision and was just wondering what this entails and how significantly improved scars can be.
Answer: Visible scars on the cheek are often significantly improved with scar revision surgery, but it really depends on the particular nature of your scar as to whether that would be the best option. For scars that are overly wide and depressed, I feel that scar revision is most likely the best option. If the scar is simply visible but not overly depressed and not overly wide, we may want to consider more advanced techniques such as Profractional laser resurfacing as I have had outstanding results with old scars using this modality.
Question: What is the best treatment for keloid scarring, steroids, surgery, or some other procedure?
Answer: I am not sure that anyone can honestly say what the best procedure for keloid scarring is, but if the keloid scarring is early, I feel that injections of steroid is the most appropriate way to prevent the keloid scar from getting larger and in most cases we can even shrink the early keloid scar so that it ultimately becomes soft and inconspicuous. If the keloid scar is on the earlobe we can also add a small pressure earring that can assist in preventing the keloid scar from forming or getting bigger. Other adjunctive measures, such as silicone sheeting or silicone gel, as well as aggressive massage can also help, but the injection of steroids is really the mainstay treatment for uncontrolled keloids. As a last ditch measure, in extreme circumstances, external radiation can actually be used for keloid scars.
Question: I am in my 20s and have exceptionally terrible acne scarring from my teen years. Will a scar revision procedure eliminate or help to reduce their appearance?
Answer: I would have to personally evaluate your acne scarring to determine what procedure would be best for you, but for certain individuals a scar revision surgery would be appropriate if the acne scarring is exceptionally deep. This will only improve the area so that other adjunctive procedures, such as ProFractional laser resurfacing can be used to further improve the appearance of the acne scarring. Most of my patients have acne scarring that is not significant to warrant any sort of surgical intervention and therefore most of my patients we simply treat with the ProFractional laser, spacing treatments about a month apart and performing a series of 3 treatments. We allow this to then heal and the far majority of patients get a very significant improvement in their acne scarring, though I do caution patients that they cannot expect the acne scarring to be completely gone, but rather our end goal is a significant improvement of somewhere between 50% and 80%. If they would be happy with this, then more than likely they will be extremely happy with the results that we can achieve.