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Rob23

Post surgery pics & Dermabrasion question

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Hey all,

Never posted here before, but I've done some reading and gotten information.

Eight days ago I had two acne scars removed. What type they'd be called, I can't really tell you. But as the picture below indicates, it was basically a deep sunken scar, with a smaller indentation to the top right of the dent (that one was thanks for a Cortisone shot I believe...)

I've had the scars for years and had increasingly grown tired of them. I went to the dermatologist, got his opinion and a referral, and was at the plastic surgeon the next day. He does a lot of acne work and he thought it would be a simple fix. Long story short, I had both the deeper scar and the smaller indentation scar removed last Friday.

As you can see by the picture, here is my before and current photo. Bear in mind its still a bit red and healing (and a bit shiny cause I had some neosporin on it ;) )

IPB Image

Now here is my question and dilemma. I was aware that dermabrasion might be needed afterwards, but was hoping for a really good results just from the scar removal portion alone. Right now, I'm not absolutely thrilled with the results. It is an improvement in many regards, but at this moment I'm left wondering if additional scars may appear that would be equally, if not more prominent.

As the pics show, there is of course an incision line. I believe this will go away, and frankly everything will look better as the redness fades. Its easy to stare at the incisions and think its horrible looking at this point. The left most incision, where the deep sunken scar was, is actually quite nice in my opinion. Once it heals it will be a definite improvement, small scar or no scar. But where I only had that smaller indentation, it was a larger incision then I expected, and now I'm wondering how that will heal. This incision (the right most in the pics) actually appears to be more sunken in and possibly a bit worse off then before. (The pics are a bit misleading in regards to the smaller indentation...it still was fairly prominent, but its a toss-up as to whether it was worse before or after the surgery).

As shown in the pics, the incision areas are still a little sunken in. The surrounding skin is a little higher, so there is still a depression there. I'm scheduled to go back in 2 weeks and based on the doctors opinion, probably get dermabrasion done that day.

The big question is, do you guys think it will work? A lot of this board has dermabrasion pics, but its for the full face, not for a spot location. Given that this spot is smack dab in the middle of my face, I am concerned. I think the dermabrasion could smooth the area out and at the least, reduce any new scars from the incisions. But I don't know if it will give me a totally smooth look overall, or if I'll still end up with smooth depressions where the surgery was performed. I'm not even sure how much surface area or where exactly he'd do the dermabrasion, so its hard for me to imagine what the end result would be.

At this point, I figure I've gone this far, I might as well do the dermabrasion. Its only a small area, should heal relatively quickly, and may finalize the improvement I've been trying to attain.

But still, I'd love to hear thoughts and opinions. Especially if someone out there had some spot dermabrasion done, please leave some comments.

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Hi Rob,

Thanks for posting pictures that gave exact idea of the procedure you did recently and the kind of problem you are trying to solve. Looking at the after pictures it seems that you might get good results once redness and swelling goes down. Left picture does show slightly sunken incision line but I feel, it is just 2 weeks and too soon to judge it. You would need to give it more time like 4-6 weeks.

About spot dermabrasion : around 8 months back, I tried a small patch ( a quarter size ) of dermabrasion on the side of my face. Before that, I had filled my acne scars using dermal grafts and was looking for a resurfacing procedure. The area where I did dermabrasion had 2-3 very small scars ( almost like pores ) and a slightly raised but filled scar ( after graft ).

This was how the procedure and healing afterwards was : the procedure was done under local anasthesia and took like 20 mins. The area was covered by some special tape ( I forgot name ) for first 2 days. It was looking strawberry red color that time. After 2 days, tape was changed and a fresh tape was put. After 4 days, it healed a bit and started looking like dark pink ( like new flesh ) and my doctor told me to keep it open but protect from sunlight. Then it slowly healed after 8 weeks. It did leave slightly brownish, pinkish tone but that is 'cause of my skin type ( am asian with skin type between III and IV ) Texture wise I got great results. Later on, I didn't pursue it as I needed it on both cheeks ( this was a test patch ) and considering a long down time and other risks especially for my skin type, I decided not to do it and opted for Fraxel. But I was happy with the results otherwise.

Things you might want to consider is : is there a risk of a demarcation in color from the surrounding area as it is in the front and middle part. Healing and blending with rest of the skin does take significant time though hard down time is just 4-5 days. Probably, you might need to use some concealer or makeup at least initially as it does look quite reddish pink during first 8-10 weeks. If you have skin type I or II, you might not have long term pigment ( hyper or hypo ) problems.

Another suggestion is about use of CP serum. If you have used it before, it might help to use it on incision lines after redness and swelling goes down some more. That might help in healing especially for sunken incision. But if you have not, it is not a good idea ( as you don't know if it suits you and can cause any additional irritation and redness ).

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Well I dont know exactly what "Skin type I or II" would refer too...I see the skin type stuff thrown out a lot, but I dont know where to read up on what each number means. And cause this message board wont let me search by a single character, it makes it tricky to find the "I" or "II" specific posts. But thats just a personal gripe with the search function ;)

On a happy note, pinkness is continuing to go away. I'll shoot some new photos in a week or so and keep everyone updated. Overall, I'm still fairly happy with my results. They of course could have been better, but I just have to remember I had scar tissue removed from my face with a pointy knife. Its bound to leave some sort of mark.

I think dermabrasion will be the correct way to go on this one. It should do a nice job of flattening out the surrounding area and make everything appear smooth. The resulting scar/line from the incision is going to be fairly minor, so hopefully it wont take a lot of aggressive dermabrasion to produce a smooth, finished look.

Oh how I wish the healing process and everything else was much faster. Where are the spiffy Star Trek medical tricoder deals that heal a cut just by waving it back and forth over the wound?

-- Quick edit: I'm seeing a plastic surgeon recommended to me by my dermatologist. He only does facial stuff, scar correction etc. I like him and must trust him, because I went through with the first step! Now here is to hoping that the dermabrasion part goes over well. I always knew it could be the final step in the process, I was just hoping to avoid it (frankly it scares me more then cutting out the scar tissue and suturing it up! Thats way easier).

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This is description of skin types ( it's there in pinned FAQ thread )

Fitzpatrick Phototype (skin types)

http://www.lasertraining.com/med-5.htm

Skin Type I - Never tans, always burns

(extremely fair skin, blonde hair, blue/ green eyes)

Skin Type II - Occasionally tans, usually burns

(fair skin, sandy to brown hair, green/brown eyes)

Skin Type III - Often tans, sometimes burns

(medium skin, brown hair, brown eyes)

Skin Type IV - Always tans, never burns

(olive skin, brown/black hair, dark brown/black eyes)

Skin Type V - Never burns

(dark brown skin, black hair, black eyes)

Skin Type VI - Never burns

(black skin, black hair, black eyes)

I wish you good luck for dermabrasion and hope that you get very satisfactory results.

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It looks like your skin type is either I or II from looking at your pics so you should have minimal complications with spot dermabrasion if you decide to do it. I know from reading the board that scars on the bridge of the nose/nose area is hard treat because the skin is so thin but it looks like you've got some improvement once the redness subsides. Who is your doctor and if you don't feel comfortable giving out his name can you tell us what state he is from? Good luck and keep us posted please.

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In your 8 day pictures, I think the healing incision lines look very neat and well-done. I hope that you get a really great result!

I'd also be interested in the name and location of your plastic surgeon if you wouldn't mind sharing it. I would really like to see a doctor who is good at small excisions and spot dermabrasions.

Best of luck healing!

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Coolbreeze, thanks for the skin type info! I guess I had missed it in the pinned topic. I'd definitely say Skin Type I or II. Somewhere in between maybe.

I'm in southern California, doctor is located in the Orange County area. If you're still curious, send a PM and I'll give the name. Dont know if they'd like their name posted all over the place, so I'm going to refrain from doing that. Well, unless until everything is healed and done with -- then hopefully I'll be back singing his praises ;)

Dance -- thanks for the feedback. Everything is healing fairly nicely, I just probably had too high expectations for this scar removal. But I can deal with a little line and some redness for the time being. The spot dermabrasion should fix that pretty well. I may stil have somewhat of an indentation, but if its shallow and smooth overall, its still an improvement.

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