Scar Aesthetics: Effective Treatments and Expert Advice for Healing

Scar aesthetic options

Hello, doctor.
I would like to ask about scar aesthetics.
I had a car accident in September of the year before last, resulting in a 4 cm laceration on my face.
In December of the same year, I sought help from a nearby aesthetic clinic and underwent wound re-suturing.
However, for some unknown reason, the wound has not healed properly (it has been continuously draining serous fluid).
During this time, I inquired with the clinic, but they responded that it was a normal phenomenon and that it would heal in a few days.
After about two weeks, I asked again, and the clinic performed another procedure to remove what seemed to be a knot from the sutures.
Subsequently, I received laser treatments and other therapies to help with wound healing and skin whitening, which continued until October of last year.
However, the scar has still not improved (and it seems that the length of the scar has even increased...).
I would like to ask the doctor:
1.
Since the treatments at the aesthetic clinic have not been effective, if I switch to a major hospital's aesthetic outpatient department, should I inform the doctor that this scar has already been re-sutured and treated with laser? Will the fact that it is not an original scar (having undergone re-suturing and laser treatment) make the scar treatment process more difficult?
2.
If I make an appointment, for a scar like this, would you recommend consulting with a plastic surgeon for autologous fat grafting or scar reconstruction? (I have researched for a long time but still do not quite understand.)

Dou Dou, 20~29 year old female. Ask Date: 2020/07/31

Dr. Lu Daokuan reply Plastic Surgery

Poor wound healing after re-suturing may be due to an allergic reaction to the sutures.
Despite receiving nutritional injections and laser treatment, if the results are still unsatisfactory, it is advisable to consult a plastic surgery outpatient clinic for a comprehensive evaluation before deciding on the next steps.
Avoid seeking hasty or inappropriate treatments.

Reply Date: 2020/07/31

More Info

When it comes to scar aesthetics and effective treatments for healing, it’s essential to understand the nature of the scar and the various options available for treatment. Based on your situation, where you have a 4 cm laceration scar from an accident that has not healed well despite multiple interventions, here are some insights and recommendations.

1. Communication with New Medical Providers: When you visit a new clinic or hospital, it is crucial to provide a complete history of your scar treatment. This includes mentioning that the scar has undergone surgical revision and laser treatments. This information is vital for the new physician to understand the complexity of your case. The prior treatments may influence the healing process and the choice of subsequent treatments. However, it should not deter the new provider from offering effective solutions. Each treatment can have different outcomes based on individual healing responses, and a fresh perspective may yield better results.

2. Choosing the Right Specialty: For your specific case, you might consider consulting with both a plastic surgeon and a dermatologist specializing in scar management. Plastic surgeons can offer options like scar revision surgery, which may involve techniques such as excision, skin grafting, or flap surgery. They can also assess if autologous fat grafting (using your own fat to fill in the scar) is appropriate for your situation. On the other hand, dermatologists may provide options like advanced laser treatments, chemical peels, or microneedling, which can help improve the texture and appearance of scars.

3. Treatment Options: Given that your scar has not improved with previous treatments, you might want to explore the following options:
- Silicone Gel Sheets or Silicone Gel: These are often recommended for scar management and can help flatten and soften scars over time.

- Laser Therapy: Different types of lasers can be used to improve the appearance of scars. Fractional lasers, for example, can help with texture and pigmentation issues.

- Microneedling: This technique involves using fine needles to create micro-injuries in the skin, promoting collagen production and improving scar appearance.

- Steroid Injections: If your scar is raised (hypertrophic or keloid), steroid injections can help flatten it.

- Chemical Peels: These can help improve the texture and color of the scar.

4. Expectations and Timeframe: Healing and improvement of scars can take time. It’s essential to have realistic expectations and understand that some treatments may require multiple sessions to see significant results. The healing process can vary widely among individuals, and patience is key.

5. Post-Treatment Care: After any treatment, following the aftercare instructions provided by your healthcare provider is crucial. This may include keeping the area moisturized, protecting it from sun exposure, and avoiding any irritants.

In summary, transitioning to a reputable hospital or clinic for further evaluation and treatment of your scar is a wise decision. Be sure to communicate your treatment history clearly, and consider consulting both plastic surgery and dermatology specialists to explore all available options. With the right approach and treatment plan, you can achieve a more satisfactory outcome for your scar.

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