LAM FACIAL PLASTICS

Hey, dr.Lam

I want to ask, I had 2 mole removed from my chest about 6 weeks ago.

When I went into the doctors office I asked if the procedure would leave scars, because I didn't want to have it done if I would scar.

My doctor said I shouldn't worry about it because the mole are at the top of the chest and that part doesn't really scar. So I was told it won't leave a scar.

Well 2 weeks later scars appeared, thick and pink.

I was told to use Contractubex gel and Vaseline after the stitches are removed. I've been rubbing those two things in every day. I rub in the Contractubex gel 4-5 times a day for 2 min. No results after 5 weeks. They go flat after I rub them but when I wake up they are raised again.

This is what the scars look like.

http://i40.tinypic.com/110a9ag.jpg

They look really small here, but are about 1.2 cm each in length. The top one is like a thick line, while the bottom line is a bit egg shaped. Now when I got the stitches removed there was a scab on the bottom one that was egg shaped.

I think they are hypertrophic scars. They haven't grown really outside the area, they don't hurt or itch.

I actually had a wart removed from my scalp a year ago and I got a thick scar, which some times is flat, sometimes is raised. But it's white. I don't know if it turned white over time or was always white because my hair covers it and I didn't really pay attention to notice. But I did notice 3-4 months in that it was white.

I'm really mad about these 2 scars, because I was told that the mole removal wouldn't scar, yet it did. Now it looks worse then it did with the moles.

I already booked an appointment to get shots. I'm thinking it's been 6 weeks since I got the moles remove I rub the gels, there is no difference so try to get the shot while the scars are still somewhat fresh so they heal right on time.

The Contractubex gel is expensive, as i rub it 4 times a day i have to buy a new one every 2 weeks. I'm on my 3rd one. I live in a small european country and that is the only scar gel you can buy here. If the shots don't work I'm gonna get a debit card from my bank and try to buy some other gels online.

I'm really upset with this, because those two moles have bothered me my whole life and I finally get them removed and it winds up being worst then before. I'm a student and I live of my own money, so it's not like I have much to spare.

Got any advice?

unfortunately, i do not perform mole removals from the chest because they ALWAYS scar unfavorably. yes, they look hypertrophic. i would treat them with 5FU and KTP laser.

Thank you for your reply doctor.

Will the scars fade to white. Cause I can somehow live with that. This dark pink is not very flatering. Also I'm getting a steroid shot today, hope that helps and I plan on using more gels.

Also they are at the top of my chest, near the neck area.

I was reading up on this and I see most doctors like you do not preform mole removal from the chest area because of scaring. I just have bad luck I guess for going to a doctor who didn't know his work. It's so upsetting to pay money to fix something and you wind up in a worse situation then before and with no money.

just be careful with the steroid shot. they can cause dermal atrophy. i rarely if ever use steroids due to the risk. i use 5FU instead but almost no doctors know about it. if you use steroids use very dilute and small amounts and stay within the dermis. but yes, you need some kind of combination of steroids, 5FU and KTP or Pulse Dye laser to help things along.
s.

dr. lam wrote:just be careful with the steroid shot. they can cause dermal atrophy. i rarely if ever use steroids due to the risk. i use 5FU instead but almost no doctors know about it. if you use steroids use very dilute and small amounts and stay within the dermis. but yes, you need some kind of combination of steroids, 5FU and KTP or Pulse Dye laser to help things along.
s.

I went in today and the doctor said that they are hyperthropic scars and we were going for the Pulse Dye Laser. He said we are not doing the steroid shot.

So he did the laser it burned, told me to buy 2 creams and rub.

And while he did the laser, he said, that he thinks it's gonna work. He told me I came at a perfect time. It was good I didn't wait too long.

Anyway He told me to come back in 3 weeks.

This stuff is gonna cost me a lot. As a student it's gonna kill my budget. I regret even going to have to mole removed now so much.

I will also like to thank you for taking a moment of your time to give me advice. It's very noble of you seeing as I live in a place where doctors don't have your education and are a bit limited.

So really, thank you.

ok, that is a brilliant plan. i totally agree. best of luck with it. i think you should be fine. sounds like what i would do to it.
s.

dr. lam wrote:ok, that is a brilliant plan. i totally agree. best of luck with it. i think you should be fine. sounds like what i would do to it.
s.

Question dr.Lam.

Few hours after the laser treatment, I have huge blisters over the sites.

Is that normal?

you need to ask your doctor that question. i try to abstain from direct medical advice to the best of my ability.
s.

Doctor I understand that you don't give direct advice. I respect that.

The blisters were drained and scabs formed and they fell out today.

NOW.

I'm gonna ask you for some direct advice and PLEASE give me some peace of mind by giving me an answer. Here or PM me the answer.

The scabs fell out and the bottom scar, looks flat a bit pink, but all in all with healing time, it looks like it would look good.

THE TOP ONE, AFTER THE SCAB FELL OUT IS BLACK. NOT BROWN BUT DARK BLACK. IT'S STILL RAISED UNLIKE THE BOTTOM ONE.

IS THIS NORMAL? I'M VERY UPSET HERE. BECAUSE I WASN'T TOLD TO EXPECT NOTHING LIKE THIS.

It looks like coagulated blood under the skin, to me.

I'll post a photo in a day or two. But please give me an answer.

honestly, i don't know the answer to your question. it could be black because the laser caused a burn injury which in most cases heals ok. i wish i could give you a better answer. i don't know if a photo would be beneficial. you should really ask your provider what is going on.
s.

dr. lam wrote:honestly, i don't know the answer to your question. it could be black because the laser caused a burn injury which in most cases heals ok. i wish i could give you a better answer. i don't know if a photo would be beneficial. you should really ask your provider what is going on.
s.

Thank you for taking the time to give me this answer.

my pleasure.

Small update doctor.

After the scabbing of the laser fell out, even the one that was black after a few days did scab and fell out. The scars looked good, especially the bottom one, it was skin color and almost flat. I was very happy, but in like a week it went back to the way it was. It didn't get any lighter.

I found Kelo-cote advance scar gel by accident and bought it. I've been using it for a month now.

It has flatten the scars. Most of the time they are totally flat, some times, like when i get up from bed, they are a bit lumpy, but soon after go flat. I also massage them. I sometimes press on them when they are a bit lumpy to flatten them out.

I'm confident if I keep doing what I'm doing, maybe I can make the be super flat all the time, like they are now, most of the time. They kind of look like they've melted to be honest.

Problem is they are still red, pink. There is no change in coloring. They might be even more red now. I assume maybe this is because the collagen has broken up a bit and the blood vessels are showing. I don't know.

Question I have is, will they fade in time and go white if I keep using gels or do I have to go get more laser done? Or maybe a shot, might help cause those speed up healing, seeing as that is cheaper than the laser.

I'm a bit unsure of the laser, because it didn't really do anything the first time and I had huge blisters, plus it cost me a lot of money. And If I chose to go that route, It'll cost me even more. But if I must I will, because the scars are on my chest are really showing. Problem also is the doctor said, that he won't do the laser close and during summer.

I basically traded two moles about 0.7 mm long for two scars that are red and lager than the moles.

At least they are now, totally flat, skin level, most of the time. So thats an improvment, thanks to Kelo-Cote.

Please If you could, give me some advice.

Thank you.

Honestly, I really don't know if the laser will improve things. In general, it does. You should monitor the progress and check with your treating physician but from this distance I really cannot help as much as I would like.

well this is what they look like now. 12 weeks out, with 3 and a half weeks of using Kelo-cote.



If that helps, they are skin level in this photo, when I run my hand over them there is no lump.

Like I said it looks like they're melted. The bottom one is round, but I guess that's because the doctor cut that one out with a bit of a curve, it wasn't a line, when there were stitches.

I don't know if the photo helps. It was taken in day light.

This is what they looked like 6 weeks out, before laser and Kelo-cote.



This photo is taken from a bit far, so they look smaller here. Plus this was when I was using Contractubex and it irritated my skin a bit, making it a bit red.

They also do not hurt or itch.