LAM FACIAL PLASTICS

My two year old recently suffered two lacerations on the middle of his poor little face. One directly on the bridge of his nose and one on the middle of his forehead. The nosebridge scar is horizontal while the forehead scar is vertical. I am wondering what options I have to prevent scarring. I am willing to do whatever it takes for my son to not have to live with these scars. They both look somewhat indented - he feel directly into a large metal seat at a local restaurant. He had three stitches to his nose, and they used histoacryl on his nose. I bought cica care silcone gel sheets as well as dermatix but since these wounds only happened a week and a half ago I'm waiting before starting treatment. When can I start with these treatments? And when can he have scar revision or laser? Please help me Dr. Lam, I am desperate and this is making me so depressed.
Daniella

hi,
of course, you really must ask a plastic surgeon in person these questions. however, in general, if you are 10 days post the incident, you could start the silicone for the first 9 to 12 weeks and that may help. there is not too much else in my opinion. if it starts to get thick, you could use laser or injectables like 5FU but at such a young age that would probably be way too risky in terms of trauma with needles and risk of eye injury from the laser and would not advise it. scar revision is a hard one to determine. in best case scenario, you don't do that for many years for a host of reasons:
1. the scarring can be dramatically worse the younger you are because kids tend to create more scar tissue than adults.
2. hopefully the wound will heal over many months to years obviating the need for any intervention.
3. anesthesia and surgery are risks that are not great for someone that young if not needed.
4. your child may pick at the sutures or fresh wound and create more problems.
in general, i would say if you can at all avoid it, try not to consider having a revision done.
best,
s.