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Improving the Appearance of Scars - Different Methods Work Best for Different Types of Scars
The way scars develop can be unpredictable, whether it’s a wound caused by an accident or a surgical incision. Many factors influence the severity of scarring, such as the size and depth of the wound, the thickness and color of your skin, the area of the body affected, the blood supply to the area, and the direction of the scar.
Anyone with visible, disfiguring scars knows how debilitating they can be but luckily most scars can be improved. Dr. Cynthia Elliott uses a combination of modalities, depending on the type of scar, including lasers, light devices, subcision (loosening the fibers under the skin that pull a scar inward) and medication injections. These treatments can reduce the appearance of scars by up 80% depending on the type of scar.
"I can't thank you enough for your amazing work on my facial scar. You are truly wonderful! I no longer have to look in the mirror & be reminded of a terrible experience I had a decade ago. Freedom! I am so glad that I found Skinspirations. You & your staff are fantastic." M. C. of St. Petersburg
What Mode of Treatment will Work Best with a Scar?
How do you know which of the many treatments available will be effective for your scar? Here are some questions I use to determine which treatment I'd recommend during a consultation and exam.
Does a depressed scar look smooth when stretched to the sides?
If a scar looks smooth when you pull the skin to either side or stretch it out, then there are parts of the scar pulling inward, and no surface treatments like lasers or chemical peels will loosen the pull. Either a filler can be injected to push the depressed area up or subcision, which involves cutting the fibers underneath the skin that are pulling it inwards, is used to release the fibers underneath the skin. Often both methods are used simultaneously as was done in these photos.
 
Before & after 1 treatment with a dermal filler & needle subcision Photos by C. Elliott, MD
"Even more important than the injections of filler I received, was the injection of self esteem she gave me." -E. Lopez, Winter Park
Does the scar look the same even when pulled from the sides?
Scars that do not appear improved by stretching them apart are usually due to defects at the surface of the skin. Depending on the type of defect, they can usually be improved by using a laser to reconfigure that area of skin. Ice pick scars from acne like the ones below, chicken pox scars and most surgical scars can usually be improved with these resurfacing lasers such as the Profractional.
 
Before & after 2 Profractional Laser treatments Photo by C. Elliott, M.D.
Treatments for Scars with Pigment Changes
It isn't uncommon for the color of the scar to change, with either a loss of normal skin color (hypopigmentation) as in the photos below, or increased pigmentation (hyperpigmentation). The fractionated laser Profractional is one of the first lasers found to be successful in sometimes restoring normal color into scars where the pigment has been lost.
 
Before and after 2 Profractional treatments showing normal pigmentation returning. Photo by C. Elliott, MD
Scar Subcision
Subcision is a nonsurgical method used to loosen depressed scars due to tethering underneath the surface that pulls the skin inward. tell if your scar will benefit from subcision? If you stretch out the skin around the scar and it looks much better, then cutting the adhesions under the skin will help get rid of the indentation. Subcision is done by using a wire or thread looped around the scar under the skin and then pulling it through to break the adhesions. Sometimes a dermal filler is injected afterwards to keep the skin from reattaching down. Some bruising can result but most scars are improved with just one treatment.
 
Before and 2 weeks after subcision of liposuction scar. Photo by C. Elliott, MD
Combination Therapies for Scars
Sometimes, especially with acne scars, there may be different types of scars that each respond best to different treatments. These treatments can usually be done during the same session so that you'll see results as fast as possible.
 
Before and after a combination of Profractional and scar subcision. Photo by C. Elliott, MD
Come into our Tampa office soon for a free consultation or call us at (727) 571.1923 to learn more about how Dr. Elliott can improve the appearance of your scars.
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