LAM FACIAL PLASTICS

Dear Dr,
i had a facial trauma 3 weeks ago and i had a lacerated wound inverted V on my nose and it is healing slowly each day is slightly better than the other but i am concerned with the scar it is going to leave and the whitish discoloration noting that it is a bit elevated than the skin also there is a yellowish crust on the left side that is adherent to the wound despite saline wash and gentle scrubbing it does not fall, i know it is too mature to judge the scar but i am very concerned and i would like to know my options as i have visited a plastic surgeon and he advised to do a scar excision elliptical after 6weeks after complete healing , and i also would like to know how to manage this wound and what creams should i use , also what kind of scar is developing now and when should i consider laser ?

Thanks

this is a tough one. honestly, you probably should have the area injected with 5FU and lasered with KTP or pulsed dye laser every few weeks and use silicone gel at home to try to get it a lot less angry and smaller before even considering a surgical revision. three reasons: you may avoid an unnecessary surgery. your surgery may be smaller if the scar is reduced first. you may have less chance of new scar tissue if the scar is operated on after it settles down. if it is responding to the medical and laser treatments i would most likely delay intervention until things settle down. how long? hard to say but at least several months.

Thanks for your prompt reply ,
I would like to inquire if the whitish discoloration is scar tissue or is is it new skin and regarding the scar what type of skin would you classify this as ?
also when should i start Treatment either with injection or laser after complete healing by how many days/weeks.also regarding 5FU how many injections do you think i will need and what about the cream?
also a surgeon told me if I used laser i will damage the surrounding skin making it harder for the revision surgery or it will not look well after surgery due to healing issues.
what type or revision surgery you think will be done ?

question
1- what type of scar is forming and what is the whitish discolored part new skin vs scar
2- when should the 5FU start and how many injections will be needed what about 5FU cream
3-what kind of revision surgery will be needed in your opinion and using laser before revision surgery decreases the cosmetically outcome so shall i jump to surgery


THANKS

REPLIES IN CAPS:

I would like to inquire if the whitish discoloration is scar tissue or is is it new skin and regarding the scar what type of skin would you classify this as ? SEE BELOW.
also when should i start Treatment either with injection or laser after complete healing by how many days/weeks.also regarding 5FU how many injections do you think i will need and what about the cream? SEE BELOW.
also a surgeon told me if I used laser i will damage the surrounding skin making it harder for the revision surgery or it will not look well after surgery due to healing issues. NOT WITH THIS KIND OF LASER. IT DOES NOT BURN SKIN. IT JUST HELPS WITH HEALING OF THE TISSUES.
what type or revision surgery you think will be done ? SEE BELOW.

question
1- what type of scar is forming and what is the whitish discolored part new skin vs scar HARD TO SAY. IT JUST LOOKS LIKE HYPERTROPHIC TISSUE.
2- when should the 5FU start and how many injections will be needed what about 5FU cream HONESTLY, AS SOON AS POSSIBLE GIVEN WHAT I AM SEEING.
3-what kind of revision surgery will be needed in your opinion and using laser before revision surgery decreases the cosmetically outcome so shall i jump to surgery IT IS HARD TO TELL WHAT IS NEEDED FOR REVISION UNTIL THE SCAR SETTLES. BUT IT COULD BE AS SMALL AS A GEOMETRIC BROKEN LINE REPAIR OR IT MAY NEED A ROTATIONAL FLAP FROM THE GLABELLA IF THE SCAR STAYS AS THICK. AGAIN, I AM GUESTIMATING BECAUSE I AM NOT SEEING AND TOUCHING THE SCAR.

Dear Dr ,
It has been nearly 45 days since my accident and i was re-exploring my options i am concerned with the color of my scar and it is so apparent and much darker and prominent than in the picture also there is a slight whitish scar on the edge of the wound pointed with arrows with a slight indentation which is felt not seen by the eyes.
i was asking about my options and could i pursue scar excision on this wound with out grafting or should i pursue laser and a conservative treatment? the scar is not elevated at all. i know that we can not judge about the scar except after 3 to 6 month but i was asking by the looks of it what do you advise?

Thank You

it looks a lot better. personally, i would not cut it out this soon. you may not need anything down the line. you could use silicone gel on there or get a light laser like KTP but just continue to let things heal.