LAM FACIAL PLASTICS

Hi Dr. Lam,

Do you think Aldara is effective in preventing hypertrophic scarring recurrence after a fusiform excision, if the cream is used on the fresh scar site (after the wound has fully healed, of course)?

Would there be any major negative side effects caused by Aldara?

i don't think aldara is sufficient to prevent a hypertrophic scar. it could help. i only use it in conjunction with treating keloids scars not hypertrophic ones. i have no real knowledge of the negatives. i only use it in one or two patients a year with keloids i have excised. don't know the efficacy with hypertrophic scars.
best,
sml

Thanks.

So besides KTP laser / 5-fu / Kenalog injections, is there anything that is effective in helping prevent hypertrophy recurrence after a fresh excision (eg. taping the incisions, etc...)?

yes, taping it and silicone both can help. i also pre-botox the area 2 weeks before or for those who fly in the day before.

How does the botox work, and would it work on a long linear scar?

Are there any side effects with this botox method? Would additional botox injections needed post-surgery?

botox is to decrease muscle stretchback. i do it in most patients getting scar revisions or mole removals. the major downside is expense and also doing it in central or lower facial areas that can affect speech for about a month. but in my opinion with bad scars, it is worth that.
best,
sml

Assuming the incision site is under tension, for how long should the paper tapes be kept on the incision after the surgery, in order to help prevent scar widening?

there is no consensus on that. i do 2 to 3 months if possible.