Dr. Sam Lam Plastic Surgery Forum

About 18 years ago I had plastic surgery to remove an acne scar. Perhaps I didn't follow the directions perfectly and kept a bandaid over it too long, I am really not sure. Everything seemed ok, but when I went to get the stitches removed instead of the surgeon there was a young girl, around 20, who removed them. At that time the wound opened up and she ran away to get the doctor, looking horrified.

He later did a dermabrasion to try and minimize it, and said it would fade into my smile line as I grew older. The end result was much a scar much worse than before, and 18+ years later it still hasn't faded into the smile line much. I have been afraid to try and correct it as the initial experience was so bad, and it has impacted my life very negatively ever since, to say the least. I am just wondering if this can be corrected or greatly improved at your practice? (it is sunken so it looks even worse with lighting overhead) Thank you very much for any advice.

there are several important things you should know:
1. first, i cannot make a judgment by one single photograph without seeing you in person and truly evaluating the scar. oftentimes, a scar in a photograph can look better or worse than it really is without an in-person consultation.
2. second, there is oftentimes a legacy of negativity left in your heart that makes things very difficult for you to bear because a) you can't forgive yourself for having picked that surgeon, and usually less so but still important b) you can't forgive the surgeon for having done something that in your opinion is less than ideal. whenever i do corrective work, i am faced with a poor previous relationship that clouds my ability to help someone in very subtle but profound ways. in other words, whatever i do for you you will always "see a scar" because first a scar revision always entails changing one line that is more visibly hopefully for a line that is less visible and b) your heart is still living with regret. that must be cleaned before i can work on something.
3. third, fortunately, your scar looks as if it falls into a natural nasolabial crease but i understand that it is still imperfect. i don't know to what extent it will be improved given what i see.
4. fourth, scar revision is a major thing. it takes a long time for it to look good again with a lot of postoperative follow up with laser, dermabrasion, and possible 5-FU injections (scar reducer) to make sure the scar looks good. meaning two things to consider: a. you will have a protracted time upwards of a year or more where the scar will most likely not look better but could and will look substantially worse., b. as said, there is a lot of after care to make a scar look good that may be needed.
5. fifth, there are no guarantees in life. anytime you rework a previous scar, it could look better, same, or even worse. you have to understand all risks benefits to decide. looking at a scar in person can help but my suggestion is to find someone local if you are not in Dallas to help you.
in summary, clean your heart and soul about your past. you might find you don't want a scar revision after all. when the emotional scar is gone and the legacy effaced, you might not need to undertake something that will literally reopen old wounds. hope that helps as a start.
best,
sml

Dear Dr. Lam,

After incurring a facial laceration, I've been researching potential Doctors who might be able to help reduce the appearance of my scar. I've visited your website several times hoping that when I could schedule an appointment for a consultation, I would fly out to your office and finally get a expert opinion on my scar. However, after reading your statement regarding the intensive postop follow ups, I began to realize that, much to my chagrin, it isn't realistic to begin the process with you if I have to fly back and forth numerous times for proper postop treatment! That said, I live in Ohio and I'm wondering if there's a plastic surgeon in, or near, this state that YOU feel is as competent, capable, and just as good as you, that YOU would be willing to recommend to someone who is very serious about having there scar revised. I'm REALLY hoping that you could point me in the right direction as I don't want to go forward with a surgeon who isn't up to the task, much less, end up with something worse than it already is. Any and all assistance that you may provide would be GREATLY APPRECIATED. Thank you.

unfortunately, on this forum, i cannot make those recommendations. however, i wish you the best to find the right person for you.
best,
sml