LAM FACIAL PLASTICS

Edit: didn't realize you were strictly above the neck, any advice would be awesome. I understand this is not your area of expertise.


Hey dr. This is a picture of a burn which turned out to be much worse than it needed to be - super athletic and was unaware of the dangers of not allowing correct healing.. I generally do not scar on cuts, scrapes, etc. I think burns are pretty much a instant scar for anyone.in light of that I was wondering your thoughts on excision of this scar. From what I can tell it is hypertrophic - its six years old, raised, never stretched past boundaries of injury site (can you confirm this?). I'll be honest, I haven't tried other methods other than some creams which, as I'm sure you know, don't pose any fight towards keloids/hypertrophic scars. I would like to have excision. I would be more than happy with the resulting scar, I'm assuming it would be about an inch line going down my arm and I think it would be not nearly as raised. I would also be applying pressure and using sheets to make sure it didn't become raised again. My main concern is the shape of it currently.

Again, I would be happy going straight for excision - its 6 years old I doubt too many other things will work, this is a unique scar. In my opinion, the stitched up excision scar would be less severe than the initial burn...consequently I think it is a safe scar for scar substitute. What are your thoughts on this? To put it to scale, the current scar fits in an inch by inch square. Sorry if this is wordy, I cannot tell you how grateful I am for a response.

this really does lie beyond my expertise both due to the location and the type of injury, i.e., a burn. you might want to consider more conservative methods first like KTP/PDL laser and 5FU injections to soften the scar. that may bring it down enough that you avoid surgery or alternatively make surgery easier, smaller, and perhaps more successful.

dr. lam wrote:this really does lie beyond my expertise both due to the location and the type of injury, i.e., a burn. you might want to consider more conservative methods first like KTP/PDL laser and 5FU injections to soften the scar. that may bring it down enough that you avoid surgery or alternatively make surgery easier, smaller, and perhaps more successful.

Would it be a terrible decision to just go straight for surgery? Again, I am only speaking on what I have read in many cases in which, as I'm sure you know, I have seen several trends and also several deviations. Everyone's different. Anyways, I'm a bit limited on time and hoping to get this all figured out is summer.. Wouldnt ? injections or laser only help to flatten the tissue, not recess the boundaries. Additionally, wouldnt a surgery on the current scar require the same surface area as the flattened scar? I would be happy with a straight surgical scar.

Again, I cannot thank you enough for all the whole-hearted responses you give on this forum - it's incredibly hard to find doctors like this. I understand this is not your area. This will be my last post .

no problem. honestly, i don't have a good answer for you. i personally would try to shrink it a bit and calm it down but i don't think necessarily going straight to surgery is a wrong them. just find a qualified person to do it for you that can weigh the pros and cons well.
best,
s.