Dang Nabit, How Can I Improve This Facial Scar?

Did you ever take a bad fall as a child? Did you ever have an evening where you drank too much in uptown Charlotte? Or have you had an accident when you got hit in the face and now you are left with a bad facial scar?

Some facial scars are secondary to violence and may be a daily reminder of a traumatic event in your life.  Whatever the cause of the scar, there are multiple methods in which they can be improved.  This includes surgical scar revision, laser treatments, topical ointments, tattoos, and makeup.

When evaluating a scar, I first ask the patient what is their main concern about the scar.  Common concerns are:

• Wide scars
• Scars that are a different color than the remainder of the skin  (Either darker, lighter, or red)
• The texture of the scar is different from the surrounding area of the skin

The answers to these questions will guide my treatment recommendations.  Let’s take each concern and analyze the possible solutions.

Wide Scars

A wide scar cannot be narrowed non-surgically.  The way to treat these scars is by undergoing a scar revision procedure in which I make a new scar that is less noticeable.  The eye is typically drawn to straight lines and so I will make the new scar with small angles and curves.  Other times, I will reorient the scar into a direction that is more pleasing.  The medical term for these techniques are z-plasty, geometric broken line closures, and w plasty.

Scars That Are a Different Color

If a scar is red, then there are lasers which can treat the scar. V-beam is a favorite and can remove the red.  In scars that are darker than the surrounding skin, a topical lightening cream can be used.  In scars that are lighter than the surrounding skin, then we may use micro tattoo techniques.  This entails making many tiny holes with a needle.  This can stimulate your body to deposit more pigment.  If these conservative methods do not work or the patient would like the scar removed then surgically removing the scar would be an option.

Different Texture

Laser resurfacing of the scar can help even out the texture.  This may entail lasering just the scar or may require laser to the area around it.  If the texture is very different than the surrounding tissue then many times I will suggest a surgical scar revision as previously described.

As a facial cosmetic surgeon in Charlotte, I am always thinking of multiple options both surgical and non-surgical, for my patients.  All patients have different goals and there are many factors that guide my treatment recommendation.