DALLAS SCAR CORRECTION: HYPERTROPHIC SCAR VS. KELOID

[MedicalTourismCR1]

Cool Channel Thanks.

[SlabbMuzickEnt]

Hi Dr. Lam, I have keloids on the left and right side of my face. I've tried injections but they only seem to work a little for about a week and the keloids go back to normal size. I want to know what you would suggest, Im located in Shreveport so coming to your facility would'nt be a problem. I also have pictures if you would like to see the keloids on my face. Please help I'm desperate!!

[samlammd]

@SlabbMuzickEnt unfortunately, in my experience you will have to have them excised and have scheduled radiation immediately following. so you will have a "scar" or line but i think it should be better than your current keloids. just injecting them leads to repeated failure. if you are interested, you can call my office 888-866-3388 but you will have to stay in dallas for coordinated radiation for 5 consecutive days.

best,

sml

[ZachMaccc]

Thank you so much. Knowing that a keloid is almost impossible to appear on the central face is comforting as I have a small scar 1mmx1mm on my cheek area close to my nose. Can Hypertrophic scars grow or thicken a little bit over time? My small scar had developed from a pimple that scarred flat, now it is like a cross between a pimple and a wart, but blends with my skin tone. Is this anything to worry about? I am visiting a dermatologist next week.

[samlammd]

@ZachMaccc check with your dermatologist but you may have a hypertrophic scar that can be managed with laser and 5-FU injections as needed.

[Singrochester]

Okay thank you but what treatment would you suggest strongly for me, i dont' want general treatment, the doctor i trusted incised me and got this scar from a mole removal a small one too...it disappoints me so fill me in on whats best with it being there already.

[samlammd]

@Singrochester as i said, i cannot offer medical advice without seeing you and making appropriate recommendations. this q/a section is for general guidelines. sorry about that.

[Singrochester]

so if you surgically got a hypertrophic scar out of your chest, it would not reoccur? i really want to get rid of it and would rather have a mild thin white scar than a hypertrophic scar, so is that safe? and will the laser therapy after, prevent a reccurance? ANSWER

[samlammd]

@Singrochester to get the right answer, you would need to see a physician. however, in general hypertrophic scars or keloids of the chest can reoccur. sometimes they do not need excision but just management with laser and injections of steroid and/or 5-FU. other times they need excision plus the injections. almost always they will need management of injectables to minimize recurrence.

[WattsyName]

thanks, that information was very helpful. all the best.

[samlammd]

@WattsyName you are welcome!

[MegaCharlatan]

Hi Dr Lam, I have Hair transplant cobblestone scars on my forehead, have you any experience of these?

[samlammd]

these are not easy to manage. they need to be shaved off and possibly dermabraded. if they are not bad and there is still room in front, you can place grafts in front to de-emphasize them.

[MegaCharlatan]

@samlammd Thanks, I went to a bad HT clinic they put minigrafts in my temple points :(

[samlammd]

i am so sorry to hear that. sometimes, it may be better to just remove those than transplant around them, especially if the angles are off in the temple. that is hard to fix by shaving because the temple should be very flat in angle and small grafts. if the sizes are large and poorly angled, it may be better just to remove them. so sorry to hear of your situation.

[MegaCharlatan]

Thanks so much, would you recommend FUE to remove these, would it leave scars

[samlammd]

i would have to see them but yes most likely you need them punched out.

[samlammd]

i believe i answered this on my forum. these are not the easiest to manage. of course, i would have to see it to determine the best course of action.

best,

sml

[tHEMACTIVEjERKS408]

if i have a small hypertrophic scar behind my ear (I had gauges aka huge holes in my ear) and took them out. Now there is a small slightly raised scar about the size of a pencil eraser. Can I re-pierce the scar without consequences? Thanks

[StimpsonJKat]

Dr. Lam, I really enjoy watching your videos, I find them very helpful. Have you witnessed hypertrophic scars forming after any mole removals? In other words, are they avoidable with the careful and professional work of an experienced plastic surgeon such as yourself or is it unavoidable with particular skin types? Thank you for your dedication to the online community,

Matt

[samlammd]

i can't recall any cases but it is absolutely possible with any procedure. sometimes early on a scar can thicken and that is why it is important to manage it early. for example, at 3 to 4 weeks out, if it starts to look like it is thickening, i use KTP laser and 5-FU injections to keep it from becoming a full hypertrophic scar. in addition, silicone sheeting and taping can help.

[r2nd0mw0rld]

i have a scar on my tounge i bit threw it when i was 4 i did a flip off my parents bed and ive had it ever since

[samlammd]

hmm, i have not had to manage a tongue scar.  would have to see it to see what to do if anything.

best,

sml

[AznShin3]

i have a scar like under my lip when i was little i was like running around and i hit a chair with it and i have had it since like 4 i think my parents said they didn't do stiches

[samlammd]

obviously, i would have to see it to determine whether it is worth treating or no or how.

[gogoutube]

Hi Doctor. I am just wondering for a small, hard hypertrophic scar.. how effective are steroid injections? Will the scar become soft and flexible like the skin around it? Also, how many injections (and time) are required to flatten a scar about the size of a long-grain rice. It's on the corner of my eye, from surgery.

[samlammd]

sorry, i thought i answered this. this is hard to say since every scar no matter the size responds differently. in general, i do not use a lot of steroid because of risk of "atrophy" where the skin can dip. i prefer 5-FU unless it is a keloid then you have to use steroid to make a difference. in general i use laser too but your location near the eye would not be safe to use a laser. the laser (KTP) is not to burn the scar down but to modulate the collagen to soften it.

[jjayprock25]

I have a Hypertrophic scar about the size of a pencil eraser and its on my right arm by the crease of the elbow...i was wondering if i get surgery will it grow back 2wice as big? or what would be best?

[samlammd]

sorry, i only work on the face.

[yorkca]

I have a large keloid at the back of my neck at the hairline. I had a much smaller one removed from the area years ago and now it have blown up to several times the original size. In fact I think he even left some of the sutures in place. I went to another doctor who tried steroid injections, this did not help at all. I live in the central Oregon coast, is there anyone in this area that you could recommend who would have experience working this type of large keloid ?

[samlammd]

sorry, i cannot give recommendations here. just make sure you get someone who understands the pluses and minuses of radiation for you, which might help your situation, especially doing it within 24 hours after a good surgical excision.

[happypeace07]

Hi, your video has been really useful! I have a few hypertrophic scar on my nose caused by acne. I really want it gone as it's in the center of my face. I would like to ask you some questions. I have very thick skin on my nose as well(my doctor told me). It make my nose larger than it should. Is it treatable? can it be treated like hypertrophic scar? Your answer will be much appreciated!! =)

[samlammd]

i don't think you can treat thick skin like a scar. i have never done that.

[samlammd]

1. it would look better only if you do surgery first.

2. see #1.

[nikkifam0us]

do you have an email? i have accouple questions..

[afropete83]

what about for acne scars, is chemical peel or tca recommended?

[samlammd]

no, please watch my videos on acne scarring. yes to high intensity tca but this is not a standard "chemical peel" and only in experienced hands and only in certain types of scarring with full understanding of your recovery.

[afropete83]

I have keloid scars on my face and couple on my neck. I've tried injections, but i was wondering if chemical peel like a TCA peel is something that I can consider. What are your thoughts?

[samlammd]

no, no, no, no, no unless you want them to be 50 times bigger.

[cloudfire777]

Hi samlammd. I have a question for you. I have 9 small keloids located on my left shoulder. Right on the edge of it where the skin begins following to the arm. That is the ONLY area where i get keloids due to acne. Ive had acne a lot of other places but i only get them on my left shoulder. Why? And to my most important question of them all: Are there any way to combat these keloids. Im thinking about surgery to remove them all in one cut, and treat with 5-FU and steroid afterwards? Thanks :)

[samlammd]

my specialty really is the face. with that being said, whenever you cut a keloid out you risk a massive growth of it to scary sizes. if you are going to try to cut one out, you should only try one in an area that is more forgiving (you decide). also, if it is truly a keloid and not just a hypertrophic scar, then you must absolutely need followup injections or it will almost certainly blow up in size and aggravation. check with your doc about all this though.

[Scardacious]

I have a lot of self inflicted scars on my arms and legs (resulting from cutting). And they seem to be of the keyloid nature that you are talking about....

Is there any reasonable treatment for scars like that? and for as many as I have (80 cuts or so on my inner forearms, inner upper arms, inner thighs, outer thighs, calf)?

I am 27 years old, of korean/white race and no diseases that I know of. Not sure if you needed that info...

[samlammd]

first, obviously i assume you have someone helping you with your disposition that has led to the this problem. second, it is beyond this thread to offer true medical advice of any kind. obviously, you should probably fix them when you and your physician have established that you would not continue creating new ones. third, really my specialty is the face. you need to ask a plastic surgeon who works with bodies on this one.

[Scardacious]

I have stopped, that's why I'm looking into scar correction. I didn't realize there were specialities regarding face and body.  Either way tho, you provided a lot of helpful insight and I thank you :-)

[samlammd]

i'm glad you are doing better. most PS do both face and body. i am specialized in doing just the face. glad i could be of help.

[Scardacious]

I plan on getting my nose done actually. So I hope you are still practicing in a couple of years lol Cause when ppl ask if I had found a doctor yet, I say yes, and that it's you.

[samlammd]

thank you. that is very kind!  best wishes.

[oneeyedboxer]

Thank you, good info

[samlammd]

you're welcome. thanks for viewing it.