When you injure your skin through instances such as burns, cuts, lacerations, acne, chickenpox or previous surgery, the area develops fibrous scar tissue. Depending on your age, skin type and the location of the scar, and the scar’s healing process, the scar can widen, become red, discolored, raised or hyperpigmented – which can cause self-consciousness and even restrict movement in the skin or limbs.
Surgical scar revision, also called scar removal, fades a scar that is not cosmetically pleasing, or has reduced function or movement in the area. While scar revision or reduction treatments cannot completely remove a scar without there still being a scar in its place, it can dramatically reduce the size or appearance of scars1, and any tightness or stretching of the skin.
Patients will often require a combination of treatments to achieve their desired outcome. At his offices in Manhattan and Garden City, Long Island, Dr. Cameron Rokhsar performs scar treatment to reduce the appearance of scars.
*Results may vary.
There are several types of scars, influenced by how the scar heals, or what caused the scar.
Acne affects up to 60 million Americans annually. Of these, 20 million will have severe acne, often leaving them with scars. These scars can have a variety of appearances, and fall into four types – boxcar, icepick, rolling and keloid.
Keloid scars occur when the skin ‘over-repairs’ itself after injury, producing too much collagen. This results in a raised or protruding scar which grows beyond the site of the original injury. These scars often appear red and can be itchy, and can restrict movement if they occur near a joint.
Similar to keloid scars, hypertrophic scars are formed by overproduction of collagen during a scar’s healing process, but do not grow beyond the site of the injury. These, too, are red and raised and often itchy, and require treatment.
Contracture scars occur after burns and often penetrate deep into the skin – affecting nerves and muscles below the surface of the skin. As the name suggests, they cause tightening in the skin, which affects movement and can be painful or uncomfortable.
Treatment for surgical scar revision2 is a very personalized process – with treatments chosen based on a patient’s age, health and skin type, as well as the size, location and type of scars they have. This highlights the importance of choosing an experienced, board-certified specialist to undertake your scar revision. Scar revision3 treatments include:
Fraxel laser is an advanced skin resurfacing technology which triggers the body’s natural repair response to reduce the appearance of scarring. Dr. Rokhsar was one of the pioneers of the fraxel laser and continues to lead the way in training and innovation. Dr. Rokhsar’s protocols for treatment of acne and surgical scars with the Fraxel laser are followed around the world as Dr. Rokhsar helped develop the fraxel laser through the early FDA clinical trials in 2003-2004.
Similar to Fraxel laser, fractional CO2 laser resurfacing regenerates the skin to improve its texture and tone. Fractional Co2 laser resurfacing has shown much promise in the treatment of a variety of scars, but especially hypertrophic, tight, contractured scars commonly caused from burns especially on the face, hands, legs, the torso and the feet. This laser evaporates scar tissue in a controlled fractionated manner stimulating the body to create new skin to replace the scarred skin. Contractures and tightness can get better after a few sessions with this laser. As this is a very tricky laser and tricky technique, you must choose a doctor with vast experience in the treatment of scars with the CO2 laser. Dr. Rokhsar is considered a world expert in the treatments of scars and wrinkles with the CO2 laser. Dr. Rokhsar trained with the late Richard Fitzpatrick, who is considered the father and inventor of CO2 laser resurfacing. Dr. Rokhsar gets referrals from numerous dermatologists and plastic surgeons from around New York, and the tri-state area and from around the country and the world.
Oftentimes, many scars including scars from cuts, trauma, burns or even acne scars appear red in color. This is because scars are stimulated to grow abnormal scar tissue due to an abundance of blood vessels feeding the scar ths giving its red appearance. Vascular lasers including the pulse dye or the Vbeam laser are an important adjunct to the treatment of many types of scars. These lasers specifically interact with the red color of the scar and diminish the blood vessels that supply blood to the scar. By doing this they help scars calm down, not only in their red appearance but also in their texture, hardness, and toughness. Dr. Rokhsar may advise you to have the pulse dye laser treatment alone or in conjunction with another laser modality. Dr. Rokhsar is considered a world expert in the treatment of scar with a variety of lasers.
Many scars appear hollowed out or depressed in nature. When these depressed scars occur as a result of acne scars, they are often referred to as rolling scars. Scars can also appear hollowed out or caved in other parts of the body as well. Dr. Rokhsar employs a technique called subcision for treatment of these scars. Subcision helps build our own body’s tissue in the area of the depressed scar, creating a smoother contour appearance. Dr. Rokhsar first numbs the area locally. He then uses a special instrument to free up the bound down depressed scar from the underlying tissue. The body replaces this space with normal tissue to create a more even appearance and improve the caved in look. Dr. Rokhsar is highly experienced in the techniques of subcision. Other doctors often refer their tough scar cases to Dr. Rokhsar for his special expertise in this subject.
Scar tissue is often thick. This thickness stems from the over-growth of abnormal thick collagen in the scar tissue. Dr. Rokhsar uses a special formula of an appropriate concentration of a steroid in conjunction with a drug called 5-FU. This combination is highly synergistic and breaks up scar tissue expeditiously. Multiple injections are required at monthly intervals. Dr. Rokhsar’s results employing this combination for treatment of hard raised scars are unmatched.
Sometimes, an incision is needed to alter or reduce the appearance of a scar. There are several techniques surgeons use during scar revision surgery, depending on the size and location of the scar. As an expert reconstructive surgeon, Dr. Rokhsar can advise you if a surgical revision is right for you. If you chose this route, You can rest assured that you are in the care of highly skillful surgical hands with over 25 years of experience. Dr Rokhsar uses highly advanced surgical suture techniques with sutures buried under your skin so that you won’t get track marks. Since Dr. Rokhsar uses both surgical and non surgical methods to improve your scar, you have many options at your disposal. You, along with Dr. Rokhsar will come up with an individualized plan to address the specific type and nature of your scars.
If you have scarring that makes you feel uncomfortable or self-conscious, transformation could be just a phone call away. Contact Dr. Rokhsar for a confidential, personalized scar removal consultation.
Scar revision is a type of surgical or non-surgical procedure done on a scar to improve its appearance, restore function, or reduce discomfort caused by itching. Scars are unavoidable results of injury or surgery, and they are marks left on the skin after wounds have healed. Scar revision procedures vary from creams and non-invasive treatments to surgery, depending on the type and severity of the scar. The aim of scar revision is to help the scar blend in more closely with the surrounding skin color and texture.
There are different types of scars, including discoloration, surface irregularities, hypertrophic, keloid, and contracture scars. Scars can also be red or brown. Scar revision treatments recommended by a board certified dermatologists depend on the type of scar and may include laser resurfacing using the Fraxel laser, CO2 laser resurfacing, subcision, surgical revision, pulse dye (Vbeam) laser treatments, cortisone injections, 5FU injections and other possible treatments for your particular scar. Dr. Cameron Rokhsar is considered a world expert in the treatment of all types of scars.
There can be several reasons why a surgical scar may itch. When the skin is injured, the nerve endings can become damaged, making them very sensitive and prone to itchiness. Scar itchiness can also occur as a part of the natural healing process, as the body regrows skin cells. Furthermore, it is not uncommon for the body to have an inflammatory response to the surgical trauma, which can result in itching. It is essential to contact your surgeon or dermatologist if the itching is severe or persists for more than a few days, as it could be a sign of an allergic reaction to surgical materials used or an infection starting. In some cases, itching can be a sign of abnormal healing, such as inflammation, redness, or oozing. Nerve endings being severed and cauterized during the surgical process can also result in scar sensitivity and itching, which is a normal part of the healing process. The release of histamine can also cause scar itchiness by activating nerve fibers in the skin that signal the brain there is an itch.
Healing a surgical scar can take time, but there are things you can do to promote healing and minimize scarring:
Laser scar removal is a non-surgical procedure that uses focused beams of light to reduce the appearance of scars and help them become less noticeable. Laser therapy can be used to treat a variety of scars, including surgical scars, acne scars, and keloid scars.
There are two main types of laser treatments which can be used for scar removal or improvement. CO2 laser therapy and fractional laser therapy are the top two choices for treatment of many scars. CO2 laser therapy removes thin layers of skin with a high-intensity laser, while fractional laser therapy delivers the laser energy in small, closely spaced columns, leaving healthy tissue intact. Both types of laser therapy stimulate the growth of new, healthy skin cells, which replace the damaged scar tissue. Other lasers used are vascular lasers such as the Vbeam laser to decrease the red or purple appearance of a scar. Pigment lasers like the q-switched alexandrite or ND YAG laser or pico lasers can be used to decrease the brown color of a scar.
Laser treatment can also prevent raised scars from forming after surgery, reduce scar pain and itch, and increase range of motion if a scar limits movement.
The procedure is usually performed by a board-certified dermatologist and is an outpatient procedure. The area is first numbed with a local anesthetic or a numbing cream to ensure minimal discomfort during the procedure.
Subcision is a treatment used to correct a type of scar called a valley or rolling scar. A valley scar simply means there is a defect in the volume of the skin at the site of the scar. The goal of subcision is to improve this decreased volume. Suncision can also treat surgical scars that appear tethered or depressed. By freeing up the bands that pull down the scar tissue to the underlying subcutaneous tissue.
Subcision treatment breaks up the bands that pull the scarred area down causing the depression in the skin. This also allows for the formation of new, healthier tissue.
You can expect to see results within a few weeks: sometimes the results of subcision are immediately visible. Final results are seen within 1 to 3 months. The skin will continue to remodel for up to a year following treatment. Subcision may have to be repeated 1-3 times depending on the type of scar.
Subcision is a simple and safe office surgery procedure for treatment of depressed scars. It can easily be combined with other treatments such as laser, fillers and scar revisions for maximum efficacy. Dr. Rokhsar is an expert in subcision and combined scar procedures.
Mole removal scars can be treated using various medical remedies. Medical options include silicone gel sheets, polyurethane wound coverings, laser treatment, injections, pressure treatment, and surgery. In addition, moisturizing ointments such as petroleum jelly under a bandage can be used to reduce scar formation while the wound is healing. After the scar tissue has formed, steroid injections can be used to soften or flatten the scar. It is also important to keep the mole-removal wound moisturized with a dab of simple white petroleum jelly to accelerate healing and reduce the potential for scarring. Overall, the choice of treatment will depend on the type and severity of the mole removal scar. Dr. Rokhsar can help determine the best option depending on the type of scar.
You can get laser scar removal done in a board certified dermatologist office. The doctor will use a local anesthetic on the treatment area in the form of injections or numbing cream to ensure minimal discomfort.
Dermatologists often use more than one treatment for scars to achieve the best results. For example, a dermatologist may treat deep acne scars with a laser and also use a filler to improve their appearance. Dr. Rokhsar is a double board certified dermatologist and dermatologic surgeon with specific fellowship training in laser surgery. He uses over 40 lasers and energy based devices between his offices in Manhattan New York and Garden City Long Island and is a referral center for many dermatologist and plastic surgeons to treat scars from surgery or trauma. Among the scars treated by Dr. Rokhsar include, red scars, depressed scars, keloid scars, hypertrophic scars, surgical scars, breast lift scars, breast implant scars, liposuction scars, mole removal scars, acne scars, burn scars, dog bite scars, white scars and many other forms of scarring.
The cost of scar revision procedures can vary depending on factors such as the type of procedure used, the area it covers and the extent of the scarring. The degree of improvement that can be achieved with scar revision will depend on the severity of the scarring, the type, size, and location of the scar, and the individual’s response to treatment.
Upper East Side Manhattan Office
121 East 60th Street, Suite 8AB New York, NY 10022
(212) 285-1110
Long Island Office
901 Stewart Ave, Suite 240, Garden City, NY 11530
(516) 512-7616
References
Dr. Cameron Rokhsar, MD, FAAD, FAACS, is the founder and medical director of the New York Cosmetic, Skin, & Laser Surgery Center. Dr. Rokhsar is a graduate of Harvard College and NYU School of Medicine. Dr. Rokhsar is double board certified in dermatology and micrographic dermatologic surgery, being one of the few select dermatologists in the country who is also fellowship trained in laser surgery. A researcher and innovator, Dr. Rokhsar is the creator of the non-surgical nose job and has been instrumental in the research and development of laser systems such as the Fraxel, CO2, Mirady, Vbeam, Themitight, and Ulthera devices. An Associate Professor of Dermatology at Mount Sinai Hospital in NYC, Dr. Rokhsar actively teaches the cosmetic dermatology clinic to the resident at Mount Sinai. An expert injector of fillers, and a trainer for many companies, patients fly in from around the world to see Dr. Rokhsar in his Garden City and Manhattan offices in New York.
Dr. Rokhsar was chosen by
magazine as a top dermatologist in its Best Doctors 2017, 2018, 2019, 2020, 2021, 2022 and 2023 issues.
