Q: Dear Dr. Eppley, I have a question for you concerning the removal of some subtle scar tissue. The scar is above my lip and was caused from a small burn from a do it yourself type laser hair remover. The initial wound was not very deep and I didn’t think it would even cause a scar, but it has in fact left my skin a bit irregular in a very noticeable place on my face. I was curious if the irregular area could simply be excised, since the effected tissue is not very deep, and then the new wound could be healed with ACell to restore normalcy to the skin in the area. Would that be possible?
A: Burns create unique scars that can be very difficult to treat. Rather than a more discrete amount of scar in a linear pattern, most burn scars have a larger surface area geometry. This often makes it very difficult to simply excise them because they are too wide. With burn scar excision, the surrounding tissues will often become distorted with the closure. There are exceptions to the burn scar problem which can do well with excision but they are in the minority.
I suspect when you are talking about excision combined with Acell you are referring to a topical approach. Rather than a full-thickness excision, you probably mean just remove the surface burned tissue and cover it with Acell. Your premise is that it would heal completely normal in appearance. Unfortunately, this is not what would happen and the result would not be an improvement and likely will look even worse. I believe you are assigning healing properties to Acell that are beyond what it can really do.
Dr. Barry Eppley