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Arthroscopic Scars: Arthroscopy is a specialized orthopedic technique that uses video cameras instead of large incisions to diagnose or treat ligamentous, tendinous, or bone-related joint issues. Orthopedic surgeons have used this technique, employing small incisions near the joints of the shoulders or knees, instead of making large incisions. Arthroscopy can minimize linear scarring, but there still is a potential to develop small scars that can keloid, become red or raised, or become hyperpigmented. Treatments for hypertrophic scars from orthopedic surgery is usually limited to scar lasers and scar therapy injections. Dr. Karamanoukian usually treats these patients with advanced techniques to limit scar growth and visibility. 

C-Section Scars:

C-section scars are quite problematic in some women as they can become thick, raised, and hypertrophic.  In hair-growing areas of the pubis, abnormal C-section scars can become keloid-like, leading to symptoms of pain, itching, burning, and tenderness. The position of the C-section incision will likely determine whether the scar heals normally or scars with excess collagen deposition. There are two main types of C-section scars, one being vertical and the other horizontal. Most obstetricians will agree that the number of C-section scars is increasing every year. C-section incisions can vary in positioning and the method used to suture up the wound. Layered closure is very common with either staples or supericial sutures used. In our office, we see C-section scars quite often, with patients presenting with red and thick scars above the pubic mound. Most of these scars can improve without surgery using a combination of lasers, injections, and topical creams such as Plato's Scar Serum. 

Gastric Bypass Scars:

A gastric bypass or bariatric surgery can be performed through limited laparoscopic incisions or through large abdominal incisions that span the entire length of the abdomen. Abdominal scars caused by a gastric bypass procedure can heal abnormally with the development of keloids, hypertrophic scars, indentation, and recurrent hernias. Many of these scars can be corrected with limited incision scar revisions, lasers, and scar modulation techniques. Gastric bypass patients who have lost significant amounts of weight can opt for early scar revision or can defer treatment until after they have lost their desired weight. Vertical gastric bypass scars that have disrupted the belly button can also be corrected with realignment of the belly button and correction of the hernia, if necessary. In some cases, Dr. Karamanoukian will work alongside your surgeon to perform scar revision on your abdominal scar. 

Heart Surgery Scars:

Cardiac surgery can be a life-threatening procedure that is performed in an emergency situation in some and as an elective procedure in others. The common types of heart surgery procedures include valve replacements, CABG bypass surgery, and pacemaker procedures. All of these surgeries can leave scars. If you have undergone a sternotomy, which is an incision in the middle of your chest, you may be at risk for keloid formation and poor scarring. These procedures can cause abnormal scarring that may appear red, inflamed; and may ultimately feel itchy, painful, and uncomfortable. We have found that many heart surgery patients do not want any unnecessary surgeries with scar removal and excision. Fortunately, there are many laser and injection-based options that can limit the extent of your treatment. 

An open-heart surgery is a common procedure performed in cardiothoracic surgery and uses a mid sternotomy incision that cuts through the bony sternum of the chest. If the scar is not taken care of properly after surgery, it may develop into a thick, raised, red, and hypertrophic scar. Some sternotomy scars can become keloid and raised. 

Knee Scars: 

Scars can form on any part of the body, but it makes sense that some exposed areas like the knees may be more prone to getting injured and scarred. Skin injuries over joints are less likely to heal without significant scarring, mostly because the areas are prone to excessive tension, movement, and dynamic forces. Most of the scars that are seen on the knees occur as a result of orthopedic knee surgery, laceration repairs, and scrapes.  Occasionally, our Los Angeles plastic surgery office will see a patient with a road-rash scar on the knee that has granules of gravel imbedded within the scar tissue. 

Treatment of knee scars begins with an assessment of the type of scar. If your knee scar has hypertrophic or keloid features, it is important to begin the scar treatment protocol with lasers and injections that can smoothe the thickened tissue and reduce scar inflammation. Once the scar has softened, non-ablative lasers, RF treatments, microneedling, scar modulation, and topical therapy with Plato's Scar Serum is continued to improve the texture, contour, and composition of the knee scars. 

Our office recommends either the Plato's Medicinals Dark Scar Corrector or the Melarase creams for dark and hyperpigmented scars on the knees. The combination of skin lighteners and sunscreens can improve pigmentary framing, hyperpigmentation, PIH, and scar discoloration. 

Melarase creams are used to reduce dark discoloration and pigmentation on scars on the face and body. Dark scars benefit from Melarase creams to the skin twice daily.

Liposuction Scars:

Liposuction is one of the most common types of body contouring procedures performed by plastic surgeons. Scarring from liposuction can occur at the incision sites and throughout the whole area of treatment. Scars from liposuction incisions can give away telltale clues that you have undergone body contouring surgery. Symmetrical scars placed on the body are sometimes very unnatural and can lead to an very 'done' appearance when wearing a bathing suit. Dr. Karamanoukian uses a combination of scar removal techniques using minor surgery, laser, fractional treatments, and scar modulation therapies to help reduce the appearance of the scars on the skin. Hypopigmented scars are often difficult to treat, but can be improved with fractional treatments. Contour irregularities and uneven skin after liposuction may also be a concern with body contouring. If you have severe contouring irregularities and uneven skin after liposuction, you may benefit from a liposuction revision procedure by Dr. Karamanoukian. During the liposuction revision, Dr. Karamanoukian will redefine your soft tissue contour to help erase uneven fat distribution and uneven areas of liposuction. 

Mole Removal Scars:

Moles are found on every part of the body and are often benign.  Changes in the color of moles may prompt a surgical shave or excisional biopsy. Often, these mole removal procedures end up with scars that may look more noticeable than the original mole itself. Mole removal scars can be hypopigmented, raised, red, or discolored. Our office specializes in surgical and non-surgical scar revision and we have found that a combination of lasers, scar therapy, topical application of Plato's Scar Serum, fractional RF, and surgical scar revision techniques can help reduce the visibility of the scars. We regularly see patients for mole removal who then become regular patients as they seek to minimize further scarring by having our office complete future mole removal procedures. It is often more prudent to avoid scars rather than to correct them. If you are seeking additional mole removal procedures, our office is equipped with the latest non-surgical lasers to help minimize your need for surgery. 

Pacemaker Scars: 

Cardiac pacemakers can be inserted anywhere on the torso and are usually inserted on the left side of the chest within proximity to the heart. Replacement pacemakers often require manipulation of the original incision with exchange of the pacemaker in the same spot or in a different location. If you are prone to scar formation (with or without keloids), your pacemaker scar may become red, raised, or inflamed. The ensuing scar may become visible, raised, and uncomfortable. 

Treatment of cardiac pacemaker scars are slightly more difficult than other scars because of the underlying pacemaker. Treatments should be directed at the skin surface and care must be taken to ensure that the scar treatment does not interfere with pacemaker function. 

Sclerotherapy Scars: 

Sclerotherapy is an injection-based procedure that allows vein specialists to eliminate unwanted spider and varicose veins without surgery. There are several dozen different types of sclerotherapy agents used to treat spider and varicose veins. All of the agents that are FDA-approved have one thing in common...they all have the capacity to induce scarring related to post-inflammatory hyperpigmentation and ulceration. Sclerotherapy scars can be hypopigmented, hyperpigmented, and hypertrophic. If pigmentation problems persist, they may be caused by a combination of hemosiderin and melanin deposition within the skin. Our office employs specialized laser procedures and topical treatments that can help eliminate pigmentary problems associated with vein treatment and sclerotherapy. If ulceration and hypopigmentation has developed, then texture scar protocols with fractional laser can be used to help improve surface texture, color, and contour. 

Celebrities with Body Scars: 

Liz Dawn of Coronation Street has a pacemaker scar on her left chest below the clavicle. She showed off her scar on ITV after undergoing life-saving heart surgery. 

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