Your Questions
Your Questions
Q: I am going to get a facelift and want the scars to heal to that no one will know that it was done. I have read about a Laser-Erase procedure that can get rid of the scars almost immediately. Does this really work? What are your thoughts?
A: Over 100,000 facelifts and an equal if not greater number of eyelid tucks (blepharoplasty) are performed each year in the United States. While the incisions in the eyelids and around the ears generally scar imperceptibly, patients are understandably motivated to get the best scar result as possible. Getting a more youthful appearance at the expense of poor scarring would not be a good trade-off.
Concerns about the possibility of less than ideal scarring, numerous plastic surgeons have touted an early laser scar treatment program. Laser-Erase is just one ‘branded’ name of this treatment approach. The concept is that about two weeks after facial surgery including facelifts, eyelid surgery or any other facial procedure that requires an incision, the incision line is then treated with a light laser resurfacing procedure. Some use high intensity light or IPL treatments as opposed to an actual laser. It is touted that the ‘incision is then erased with the laser’. The theory is that the laser disrupts a scar from forming in the very early stages of the healing process, thus to quote one treatment provider, ‘the incision line is banished from sight with a zap of the light.
While this early treatment of a scar sounds very appealing, there is no science to back up its touted benefits. Plus it goes directly contrary to how wounds heal in general. No scar can be prevented from occurring between two closed edges of skin. Scar formation is inevitable, and a little burning or heating of the upper part of the wound edges, will not make it disappear. Any scar benefits that subsequently occur are a result of a natural healing and scar fading process. Such early scar treatments are more about marketing and sales than they are about any form of a new revolutionary scar treatment approach.
Dr. Barry Eppley
Indianapolis, Indiana
Q: I was in a car accident several years ago and had some bad lacerations to my face. While they were sutured up by a plastic surgeon thaty same day, they have turned into some bad-looking scars. I would really like them to look a lot better. I know they can not be made to go completely away but do you think laser surgery would help? Thanks for your time.
A: The use of lasers in scar revision is useful but largely over rated. Lasers are not a magic tool for erasing scars or other skin imperfections. The public’s perception of that highly desirous quality is a function of adventurous marketing and the ‘Star Wars’ effect which still persists even today.
Most scars are a full-thickness skin injury, meaning what you see on the outside exists the whole way through the skin. Lasers are a partial-thickness skin removing tool. As a result, it is easy to see why a laser can not remove a scar. The problem and the solution are not well-matched.
Lasers have a role is scar revision but it is more for creating a smoothing effect and often is used after other scar treatments are done. The most common scar treatment is surgical excision, cutting out the scar (full-thickness) and making the scar line thinner or changing the way the scar line runs.
Because of their more superficial effect, lasers are better at removing or lessening wrinkles and other more minor skin imperfections.
Dr. Barry Eppley
Indianapolis Indiana