LAM FACIAL PLASTICS

Dear doctor Sam Lam, I recently had 2 excisions for scars, 3 and 1 months ago each.

The first one went kinda well I guess (although it is a bit indented), but there is still a stitch inside, creating a bump and feeling hard. Is it normal after so much time? Shouldn't it have dissolved by now?



Anyway, the second excision bothers me the most, because it didn't turn out so well.It's still fresh, but the scar is quite large, uneven, hard, a bit indented and really stands out. Should I consider dermabrasion? I've heard it helps blending it with the skin. Would silicon injections help? Any other suggestion?



Thank you in advance.

1. suture can be there for months before dissolving. that is normal.
2. hmm, to me the second one (forehead i assume) looks like it is stretched out. i would most likely give it time to heal. dermabrasion may worsen it from what i can see but i am NOT seeing you in person so i really have no idea until i or someone else sees you in person.
best,
sml

dr. lam wrote:1. suture can be there for months before dissolving. that is normal.
2. hmm, to me the second one (forehead i assume) looks like it is stretched out. i would most likely give it time to heal. dermabrasion may worsen it from what i can see but i am NOT seeing you in person so i really have no idea until i or someone else sees you in person.
best,
sml

I understand, thank you very much. It was probably stretched because no internal stitches were put
Do you think it will improve considerably over time? Or should I seek another excision (and take better care of it this time)?

best to wait. most likely things will look good enough (i hope) in 6 months to a year that you do not need to do anything.
best,
s.

dr. lam wrote:best to wait. most likely things will look good enough (i hope) in 6 months to a year that you do not need to do anything.
best,
s.

Thank you doctor, I appreciate your honesty and your time. One last question: Would some silicon patches I have (and a silicon gel with Vitamin E) help these scars? I've heard they are mainly for hypertrophic ones...

good question. silicone in general is to modulate hypertrophic to keloid scars but i think they may still work on even non-hypertrophic scars in terms of softening the area out a bit.

s.

Thank you again, since there is not something I can do for the second scar, do you think I it is worth it going for dermabrasion for the first one? It is kinda intended and the rough edges make it hard for me to hide it. How long should someone wait after surgery to perform a procedure like that (or a similar one, like TCA)?

in general, 3 months at a minimum unless things are improving then i leave it alone. if it is hypertrophic, dermabrasion will worsen things. all of this needs to be seen in person by a specialist. this forum is good for general info but impossible to scale down to give personal advice to a single person. sorry.