Search google for flap plastic surgery, tons of stuff comes up. Also scar revision. Post your issue with picture on realself.com and Dr.s will recommend things, or you can search for others procedures.

Thanks for the reply.

I'm tied in with a surgeon (who is a good surgeon) and I wouldn't be able to afford to go to another one. I'm worried about the flap procedure as it looks very invasive from the pictures I've seen.

I've attached a picture of my scar below. It's on the bridge of my nose and is actually bright red in person.

I had a scar revision performed - the surgeon cut out the scar in the middle and stitched the edges together. However, once the dissolvable stitches disintigrated it stretched out again.

What do you think I should do next? I asked about doing a scar revision again and leaving non-dissolvable sttiches in, but he said that can cause "railroad track" scars. He suggest a flap procedure, which he does a lot.

I'm very worried about what I should do.

Regardless of what you do get Botox, you do not want this to move and stretch (muscle right above). Ask about this.

If it were me I would post on realself.com , it's free as I mentioned and you can put this picture there. Ask About "Scar Revision" Recommendations for A Area on the Bridge of your Nose.

I would also go see another nearby plastic surgeon for a second opinion even if I am "locked in." Do not tell him you have another surgeon or what hes is doing, just ask what would you do. You can find recommendations on realself.com of PS. Are you going to a facial plastic surgeon, there are many types. I suppose a Dermatological surgeon could do this. It's very similar to Mohssurgery for cancer, they take skin from behind the ear for the scar.. If you google image that.

Flaps can be good, I would ask to see pics of other surgery's your doctor has done like this for results. Ask what stitch technique is he using, geometric is often better in a case like this. I have seen many doctors do car revision with inner and outer stitches (not all stitch techniques are the same , Facial PS are best).

They have other ways to bond the skin, glues, and devices but this is a tricky area.

So he cannot fill it (Dermal filler)? It's red because of scar tissue, fat / collegen is missing. There are lasers for this (hyperpigmentation).

That was poor of the surgeon to not have aftercare, where are the steri strips to keep it together, why no inner and outer stitches, or geometric pattern to avid stretching. They give special bandages for case like this to avoid pressure as well.

http://www.bapras.org.uk/public/patient-information/reconstructive-surgery

https://www.realself.com/question/mooresville-nc-i-mohs-laser-remove-extensive-basal-cell-carcinoma-nose-flap

I would think really really hard about this. Your gut is right, it is a pretty aggressive procedure. It will almost undoubtedly leave you with secondary scars. I think for such a sensitive part of your face, you should avoid such an invasive procedure. For me, what catches the eye is that it is indented and very red. You can get a series of vbeams for the redness. Then try a filler to raise up the indentation. I would try this first before going for something so extreme.

Exhaust all your options before going balls to the wall. There is a high probability of it making things worse. I know money is an issue, but its your face. Good luck.

Thank you for the replies, it is much appreciated!

I had the scar revision performed on 24th January 2017, so it has been almost four months. The surgeon believed that the redness would fade by the sixth month mark, but I don't think so. What you said about the redness being caused by a lack of collagen / fat is interesting, and contradicts what the surgeon said. He said that a fat injection (1ml) is an option later on to raise the scar and fill it in, but he never said it could get rid of the actual redness. I think I will mention this to him.

I don't know what stitch technique he used - I only know that he used dissolvable stitches and the nurse put steri strips on top. I actually took the steri strips off after 3 weeks as they were coming off - perhaps this was a mistake? Immidiately after I took them off the scar looked good and not red / stretched at all, but perhaps the swelling made it look good. I don't remember when but it went from looking normal to getting all red and stretched out. Should I have left the steri strips on for a long time?

Basically, his plan was scar revision -> fat transfer after six months if the scar needs raising.

If he did a flap procedure, he said he would take skin from inbetween my eyebrows, where the skin is more plentiful and not as stretched.

I am very dubious about vBeam. I had that done once on my face and it didn't help much at all. I had terrible purpula for months afterwards. At 250 a treatment, that could cost me 1000 for a full courseand a year of purpula!

He is a general plastic surgeon who works in a spire hospital, here in the uk.

Are there any specific questions I should ask him, other than the redness ->lack of collage theory?

Thanks again

PS

Are steri strips strong enough to hold a small wound together, even after the stitches are dissolved? I fear I may have removed them too soon, causing my own downfall here.

@acne_scars_acne_scar

Yes I think they gave you terrible after care. The nurse should be replacing those steri strips and changing bandages. The Dr should have looked at it several times. It could have become infected, or moved (bandages).

Why again do you need another surgery and you cannot do a filler or fat injection with Vbeam or excel v laser for the redness hyperpigmentation.

Of course when they raise it the texture will be off but you can improve texture through TCA peels, laser, or dermabrasion.

Yes I do not think the redness will fade by itself without proper laser for pigmentaiton and creams such as hydroquinone and vitamin c serum.

I do not believe as such a injection will get rid of redness, It will lift the scar and potentially avoid surgery for you, the you can work on texture and pigmentation.

They have changed Vbeam to ave less Purpura some years back now, the old mach did this. Funny many say the purpura helps fade the pigment more. There is also Quadrostar pro an excel v. Dr. Patel in London might have these no idea or a med spa.

Why do you need to go under the knife, cant you just raise the scar, resurface, and deal with the ds. It's closed after all. Seems excessive. But he is a Facial PS and they cut things. Go see Professor Chu in London first for an opinion.

Potentially: " Are steri strips strong enough to hold a small wound together, even after the stitches are dissolved? I fear I may have removed them too soon, causing my own downfall here. " Bad wound care and management by the Dr. I would have used Botox, and a better banadage system. There should have been a less linear scar made.

I contacted another surgeon in my area who also mentioned a rotational flap. I think I am going to contact my surgeon and ask him for pictures of his past results using this method.

I hear what you're saying about the vbeam and volume fillers, but it is scar tissue not normal skin. The scar revision shouldn't have stretched out like this in the first place, but I assume it happened because the skin in this area is under a lot of tension. I need to figure out a procedure where the skin won't stretch apart.

I honestly don't know what to do. My surgeon says that a repeat of the scar revision, or a rotational flap are as good as each other. But he wants to wait a full six months before doing either (i.e July).

To be honest, I feel like he doesn't give a shit about my outcome. I have suffered with acne or acne scarring for well over 15 years and I'm beyond depressed now. No one cares and I'm forever suffering and not getting out of this nightmare.

Please go see Dr. Chu London, I don't think this guy is any good (your past surgeon) or at least get a second opinion. I don't see you needing another surgery, Why can't they just raise it (subcision) with fillers and laser, then do something about the red. Please look into getting some therapy as well, this must be tough. But yes I don't think you should go with that surgeon.

/Have you tried microneedling with the http://www.derminator.com and using hydroquinone aka skin bleach cream?

I'm interested in trying hydroquinone but I don't know where to buy it in the UK?

I have thought about buying the derminator, but I probably wouldn't use it on this scar. I had microneedling done before the scar revision and it made things worse in my opinion.

I read a review on realself which says scar revisions don't work, which makes me feel pretty depressed. Is there any truth in this? https://www.realself.com/review/seattle-wa-scar-removal-beware-scar-revision-work-scarred

Would Tony Chu reply to an email with a picture? I'm not sure how to get in contact with him.

Thanks

You buy hydroquinone on ebay or amazon, look for skin bleach or lightening also. you might need laser for hyperpigmentation Excel V or Vbeam. I think Chu and another DR in my faq in London do that.

I am sure scar revisions work for some, and not for others, it depends on your surgeon and healing. This is why you goto several PS before you decide. There will be some overlapping advice.

No idea if Dr. Chu will reply by email, you'd have to email him or call. Seems everyone is in London who does aesthetics.

I posted my situation on realself:

https://www.realself.com/question/manchester-gb-scar-revision-failed?utm_content=noanswer&rsuid=3582992&utm_source=Sailthru&utm_medium=email&utm_campaign=dr.author.answer-user_authored_question#4936403

@acne_scars_acne_scar^^ I went over the postings, good job you got 4, this is very rare. I also like Dr. Lims saying he would do filler, remember I said that above, CO2 should be your last option, as most people suck in the UK / Europe.