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Facial Scars and Keloids

Treatment of Scars on the Face

Facial Scars: 

Cheek Scars: The cheeks are an important part of your face and is prone to scarring. Scars that form on the convex surface of the cheek often do not heal very well, causing permanent marks on the face. Cheek scars can be dark, discolored, indented, and raised. If hypertrophic or keloid scars develop, they may affect adjacent skin and make the cheek area appear widely distorted. Our office specializes in facial scars and we can treat cheek scars with either a surgical or non-surgical approach. Surgical therapies include excision and layered closure, subcision, or dog-ear excision. Non-surgical scar revision may include ablative lasers, non-ablative lasers, sublative treatments, scar microtherapy, intralesional injections, and scar release procedures. Often, cheek scars are linear and may require geometric scar revision to improve scar tethering and scar contracture. Prior to your treatment commencement, we usually advise patients to begin topical application of Plato's Scar Serum twice daily to help smoothe out the scar. 

Chin Scars: 

One of the most common scars seen in childhood occur at the base of the mandible at the chin. These scars tend to spread open, causing a widening of the scar and hypopigmentation of the skin. Some of these chin scars can also be indented, while others are raised and hypertrophic. Regardless of the scar type, Dr. Karamanoukian has developed protocols for scar correction that allow him to improve most scars without surgery. A small subset of patients require surgical scar excision with layered closure.

Adult men who have chin scars also complain about hair loss along the scar, a process known as an alopecia scar. If this is the case, the scar tissue has lost normal hair follicles contained in a beard, causing the scar to look patchy and white. Alopecia scars on the chin usually require surgical scar treatment. 

Cleft Lip Scars: It would not surprise anyone that the topic of cleft lip scars can consume an entire textbook, as cleft lip scars have many components that can make them visible.  There are both functional and cosmetic reasons to undergo cleft lip scar revision procedures. Dr. Karamanoukian performs several different types of cleft lip scar revisions that include ablative and non-ablative lasers, scar revision surgery, flap realignment, vermilion surgery, rotation and rerotation surgery of the lip, RF treatments, microneedling, and subcision. Many cleft lip scar revision procedures can be performed under local anesthesia. 

Eyebrow Scars: The eyebrow and eyelid skin vary in terms of dermal thickness and propensity to hypertrophy or pigment. Scars on the eyebrows are usually caused by trauma and options for removal are usually focused on restoring any areas of hair loss in the eyebrow, reducing hypertrophy and inflammation, and restoring normal skin color. A combination of IIT, lasers, Follicular Unit Extraction, and topical therapy with Plato's Scar Serum can help.

Lip Scars:

We see countless patients with lip scars that have resulted from an injury, fall, or accident. About half of these patients underwent surgical repair, with resulting scars created from excess scar tissue, misalignment of the white roll, or an absence of normal mucosa and skin. Patients who chose not to undergo laceration repair are also prone to develop abnormal scarring, with misalignment of the normal lip tissue. In many cases, the results of lip trauma include abnormal and permanent scarring. If you have permanent scars on your lips, you may be a candidate for either surgical or non-surgical scar revision. Options include scar excision with layered closure, laser therapy, RF scar therapy, microtherapy for scars, injections, and scar modulation techniques. 

Lip Lift Scars:

A lip lift is a surgical procedure that is designed to shorten the height of the upper lip. The procedure is typically performed as an outpatient procedure under anesthesia, sometimes in association with a rhinoplasty or facelift. Although the incisions for a standard lip lift can be designed to minimize scarring, the thick skin of the upper lip and nose can create thickened and noticeable scarring that may require lasers, IIT, RF treatment, or surgical scar revision. Most patients respond well to an initial course of topical scar gel with Plato's Scar Serum, followed by laser and IIT. If a linear incision is visible underneath the nose, surgical scar revision and fractional co2 laser may be required to reduce scar visibilty. The goal of surgical scar revision for a lip lift scar is to reposition the scar in a manner that it is hidden beneath and within the nostrils.

Mole Removal Scars: 

There are many different techniques for mole removal that are commonly used by plastic surgeons and dermatologists. Many mole removals are performed to diagnose an atypical looking mole or birthmark, but some moles are removed for purely cosmetic reasons. If you have had mole removal and now have a scar, chances are that there are procedures available to help you improve the look of your scar. 

Mole removal techniques include shave biopsies, excisional biopsies, incisional biopsies, electrodessication, and laser mole removal. There is no single technique that is applicable for every situation. Many of these mole removal procedures leave hypopigmented or hyperpigmented scars that have variations in skin texture. In more severe cases, hypertrophy or keloid scarring may cause further problems with your scars. 

Nose Scars: 

Many of the nasal scars we see in our office result from trauma, but surprisingly, the vast majority of nose scars are a direct result of a cosmetic nose procedure such as a alarplasty, rhinoplasty, or septoplasty. Our office is a national referral center for scar revision and we continue to see patients from all over the region and country who have permanent scarring as a result of injury or cosmetic plastic surgery. The nose is a major structure on the face and care must be taken after injury or surgery to minimize scarring. External nose scarring is usually limited to the nasal bridge, the base of the nostrils, and the columella. Some patients may even have nostril collapse and tightening of the nasal opening that is known as vestibular stenosis. 

Internal or external nose scars can be corrected using surgical and non-surgical techniques for scar revision. Dr. Karamanoukian is a scar expert and can help you identify the physical characteristics of your scar that make it more visible. In doing so, he will incorporate a scar treatment protocol that is carefully tailored to your specific needs. Nose scars can be functional and cosmetic, leading patients to have problems with their physical appearance, nasal structure, and nasal breathing. Our office's scar protocols can help you improve these problems with simple solutions that have proven efficacy. 

  • Nasal Bridge: Scars on the nose bridge can be quite visible, especially if there are textural and color components in the scar. Depending on the depth of the scar, color, and texture, Dr. Karamanoukian will discuss options for surgical scar revision vs. non-surgical laser and topical therapy to improve scars.
  • Nostril Scars: The nostrils can become scarred as a result of surgery or trauma. The nostril rim can become notched or deformed after rhinoplasty. Further, there is a likelihood of vestibular stenosis (narrowing of the nasal passages) after rhinoplasty or septoplasty. Scars on the nostril respond well to surgery, light laser treatments, and massage therapy with Plato's Scar Serum.
  • Nasal Tip Scars: The anatomy of the nose tip predisposes the area to abnormal scarring resulting from trauma, surgery, skin cancer procedures, chicken pox, and cystic acne. Scars on the tip of the nose can be corrected with several different types of techniques, including surgical scar revision, laser scar surgery, fractional laser, fractional RF, subcision, microneedling, and dermabrasion. If you have pigmentation associated with a nose tip scar, one of the earliest steps should be application of Melarase creams to lighten the skin discoloration. Hypertrophic or keloid scars on the nose tip respond well to Plato's Medicinals Scar Serum. 

Scalp Scars: Trauma to the hair-bearing scalp tissue may lead to hair loss and visible scarring. Scalp scars usually have a hypertrophic and alopecia component that makes them very visible in most social situations. The scalp is usually very vascular and attempts to perform scar revision surgery for scalp scars may be limited by continued or iatrogenic hair loss. Options for scalp scars include hair transplantation, pigment tattoos, IIT, and laser therapy. Dr. Karamanoukian specializes in scalp scars and alopecia scars and can perform FUE hair transplantation to restore hair follicles to the scar. If the scalp scar extends into the forehead or facial skin, scar revision may allow for recontouring of the scar and restoration of normal skin contour. 

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