LAM FACIAL PLASTICS

Hi Dr. Lam,

I'm going to see you in a couple of months.

Couple of weeks back I got an unfortunate scar expansion when a local doctor used radiowave ablation on a small jagged linear scar (2mm) on my nose bridge making it bigger with sides that are raised (4mm)--almost donut like with a slight depression. I had gone to her for hyperplasia removal and I hadn't even asked her to touch any scar other than the distinctly raised hyperplasia area. I have no clue why she touched a scar. Often times in scar revision we're aiming for jagged look and that's what the scar was like, but now its distinct and depressed.

I'm very fair skinned indian (3-4 type skin) and have been doing fraxel with great results. Would you do spot dermabrasion on this kind of skin to bring such a scar down before filling it ?

How long should I wait before I get this scar treated with either a filler/shave excision/spot dermabrasion/co2.

Also, I'd like to keep the scar covered with a bit of neosporin to hide it. Would you suggest anything that I can use for longer term until I get it treated.

Thanks
-- V, San Francisco

this is very hard to answer if i don't see you in person. if the scar is truly depressed then dermabrasion usually is counterproductive. if the edges are raised or rough, then dermabrasion is good. if you have both, then i would dermabrad the latter and fill in the former. as far as co2, that is rough in a fitz 3/4 skin type and potentially dangerous with progressive skin color loss. you do not do a shave excision on a scar, but you excise it out all together if it is depressed and resuture it raised to let the edges go flat, i.e., you do what is known as an eversion of the wound edges to minimize any depression later on. as far as neosporin, there is no reason to use it this far out as far as i can see. it is used in wounds that are open and fresh. that does not sound like what you have. bottom line: i can't give you more reasonable conjecture until i see and touch your problem.
best,
sml

Thank you for the answer. Hopefully I'll see you soon !!

my pleasure. see you soon!
sml