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Fixing Bad Plastic Surgery Scars

The scope of cosmetic surgery is broad, allowing surgeons to improve the lives of patients through aesthetic and reconstructive procedures. As the field of cosmetic surgery continues to evolve, innovations in surgical technique provide options to slow the process of physical aging, modify physical features to improve 'attractiveness,' and correct anatomic and developmental problems that can impair quality of life. Plastic surgery can have a substantial affect on one's self-image, quality of life, and self-awareness. 

Surgery, much like other medical disciplines, has its inherent risks. Scarring may sometimes undermine the longterm results of cosmetic and plastic surgery by overshadowing the aesthetic gains with visible scars. Our plastic surgery center specializes in the surgical and non-surgical management of scarring associated with cosmetic surgery. If you have had a cosmetic procedure and have developed scarring and unsatisfactory cosmetic results from the procedure, advancements in corrective techniques may make this an opportune time to seek consultation and treatment. Dr. Raffy Karamanoukian is one of the leading revision plastic surgery surgeons in the country and uses innovative techniques to correct 'botched' plastic surgery. His techniques may combine laser, ablative, non-ablative, surgical, injection-based, RF, fractional, microfocused US, and scar modulation techniques to improve your aesthetic results. His focus is directed to definitive corrective measures to improve your appearance and self-image. 


Arm Lift Scars: Sometimes referred to as a brachiaplasty, there are more than a dozen variations of this procedure. Arm lifts are performed for loose skin extending from the armpit all the way down to the elbow. The variations of the surgical technique differ in the incisions used and the type of plication (or tightening) of the deeper tissue. Some armlifts only tighten the skin, whereas others tighten the fascia underneath the fat. In some arm lift procedures, excess fat is removed, whereas in others, only skin is excised. Regardless of the type of arm lift scars, plastic surgeons are aware that most arm lift scars are difficult to disguise. If you have had an armlift procedure and have unsightly scars from the procedure, you may be a candidate for a revision armlift surgery or laser and injection based arm lift scar revision. We see many patients with unsightly scars from armlifts in our Los Angeles plastic surgery clinic. There are many different options for scar revision which may be categorized as either non-surgical or surgical. Dr. Karamanoukian is one of the top revision plastic surgeons in the United States and can help you improve your scar and improve your results. 

Belly Button Scars: You may think that the belly button plays no important role in abdominal aesthetics, but think again. The belly button (umbilicus) plays a pivotal role in the cosmesis of the abdominal wall and can affect the overall results of a tummy tuck procedure. During a mini tummy tuck or a full tummy tuck, the belly button can be altered, leading to changes in the shape and size of the belly button. Surgical scars used to modify the belly button may also become hypertrophic, thick, keloid, hypopigmented, or hyperpigmented. If these changes occur, they may become visible and unappealing. Many of the belly button revisions we perform in our Santa Monica plastic surgery office have hypertrophic features that make the belly button lose normal cosmetic features. The hypertrophic scarring may cause scar contracture, narrowing of the belly button, and loss of umbilical proportions. 

Hypertrophic and keloid belly button scars often do not need surgical revision, in favor of laser and topical modulation protocols developed by Dr. Raffy Karamanoukian. These non-surgical therapies can reduce the visibility of your belly button scars and can restore the natural shape to your belly button. If you have a large belly button or a visible circular scar around your belly button, you may also benefit from surgical or fractional laser-based options to reduce scar visibility. 

Labiaplasty Scar Revision: Dr. Karamanoukian is one of a few surgeons in the country who specializes in labia minora reconstruction and revision in the setting of a 'botched labiaplasty' or over-resection of labia minora tissue. He has expertise in labia minora, clitoral hood, and labia minora scar revision surgery. Most of these cases involve an over-resection of soft tissue from the area, with resulting scarring caused by dehiscence of the tissue. Labia majora scar revision usually involves control of scarring associated with labia majora surgery. A clear understanding of techniques used in labia minora revision usually requires an examination to determine the severity of tissue loss and the availability of redundant skin to recreate the normal labia contour. Skin and soft tissue flaps can be used to recreate resected and absent labia minora on one or both sides. If you have undergone a 'botched' labiaplasty procedure and have visible scarring in the area, options are available to help control the scarring and improve the look of the labia minora and labia majora.

Tummy Tuck Scars: It should not surprise you that a whole book can be written about tummy tuck scars. There are so many different variations of tummy tuck procedures performed in the United States and many of these techniques can cause significant scarring that can limit the cosmetic improvement of an abdominoplasty procedure. Our strategy for tummy tuck revision is to restore the abdomen to a cosmetically-attractive state in which the tummy tuck scars are non-visible or at the very least, able to be covered up with a normal two piece bikini. Our board certified plastic surgeon and scar expert can help you regain your confidence by revising your tummy tuck completely or simply correcting your scars. 

Dark Tummy Tuck Scars can occur as a result of a scar process known as post-inflammatory hyperpigmentation (PIH), in which the skin darkens with inflammation and wound healing. The darkness usually sets in the early phase of wound healing and can detract from the cosmetic appearance of your tummy tuck. Darkly pigmented scars are usually very difficult to improve without topical creams, chemical peels, and laser treatments. Rarely, surgical scar revision is needed to improve a dark or hyperpigmented scar. In our office, we advise patients to use Melarase creams twice daily to a surgical scar or tummy tuck scar to reduce the onset and duration of pigmentation within the scar. By reducing skin discoloration, the results of your tummy tuck will improve. If the pigmentation has set in, the effects of the Melarase creams can be enhanced with once or twice daily application of an at-home chemical peel known as Melapads. 

Tummy Tuck Dog Ear Revision: A tummy tuck can vary in terms of the length of the incision. Depending on the method used to suture the tummy tuck, the amount of abdominal fat, and the position of the tummy tuck incision, a dog ear may develop at the ends of the abdominoplasty incision. A 'dog ear' is a bundling of skin and fat at the end of an incision-line. Once the skin has healed, the excess skin and fat may have to be removed or revised with a scar revision procedure. There are different methods used in our Los Angeles plastic surgery center to help revise dog ears formed at the end of a tummy tuck incision. Liposuction, mini liposuction, VASER liposuction, dog ear excision, and suture methods are used to reduce the protuberance caused by dog ears. 


Breast Implant Scars: The most common types of breast implants used in the United States are silicone gel implants and saline-filled silicone shell implants. The surgery is often termed breast augmentation, breast implantation, augmentation mammaplasty, or breast enhancement. The primary endpoint of breast implant surgery is to improve the volumetric profile of the female breast. Breast implants are placed above or below the pectoralis major muscle and can sometimes be placed in a dual-plane position that allows for partial coverage of the implant with muscle. Incision types for breast implant surgery include the armpits, umbilicus, areola, and infra-areolar areas. Most implants are placed through these incisions and in some patients, the breast implant scars can become thick, raised, or hypertrophic. In rare cases, the breast implant scar can become keloid-like and inflamed. 

If you are experiencing unsightly breast implant scars as a result of breast implant surgery, you are not alone. Areolar and inframammary breast scars (IMF) are common and can be improved with surgical and non-surgical options. The goal of breast implant scar revision is to improve your breast aesthetics and reduce visible scarring. Our board certified plastic surgeon, Dr. Raffy Karamanoukian, is one of the leading revision surgeons in the country and can help you achieve your aesthetic goals. During your revision procedure, you can also request that your breast implant be revised with an exchange of your breast implant size, removal of capsular contracture, a breast lift, or modifications in breast implant cleavage, perkiness, or size. Other options for breast implant revision include correction of implant hardening, implant malposition, rupture of implants, implant rippling, and implant size asymmetry. 

If you are considering scar revision for your breast implant scars, or would like breast implant revision and are not considering surgery, there are some non-surgical laser and RF options to help correct your breast cosmetics without surgery. 


Eyelid/Blepharoplasty Scars: They upper and lower eyelids are prone to premature aging because the skin of the eyelids begin to lose collagen at a faster rate than the rest of the face. An upper and lower blepharoplasty often heal extremely well with minimal scarring. In some cases, the eyelid skin can become hypertrophic and raised, and may even begin to cause functional problems with opening and closing of the eyelids. The upper eyelid blepharoplasty incision and lower eyelid blepharoplasty incision has site-specific problems that differ from one-another.

An upper eyelid blepharoplasty incision can form thick or hypertrophic scars that can become raised and red. These scars can tighten and contract, leading to functional problems with eyelid opening if the scars become worse. Often, injections and lasers are difficult in this region because of the proximity to the eyeball and the risk of laser light effecting the retina. An eye shield may have to be used if laser is indicated. Most upper eyelid scars respond well to topical application of Plato's Scar Serum, massage, and surgical scar revision.

A lower eyelid blepharoplasty can scar in a completely different manner than an upper eyelid incision. In the lower eyelids, we usually see a functional impairment in eyelid tone and position, causing the eyelid to retract down and the white of the eye to show more. The lower eyelid can become thickened and contracted. Treatment of the lower eyelid blepharoplasty by Dr. Karamanoukian begins with conservative release of the scar tissue followed by surgical scar revision for ectropion or entropion if necessary.

Lip Lift Scars: Lip lifts and lip tucks are increasing in popularity as more and more cosmetic surgery options become available for lip enhancement. Quite obviously, lip fillers are the most common lip enhancement procedures performed on women. Unlike a lip filler, a lip lift procedure shortens the distance between the base of the nose and the top of the lip line. Lip lifts are also performed to turn out the lip line and make it more prominent. The majority of lip lifts have very positive aesthetic outcomes, but some patients will develop severe scarring that can take away from the aesthetic results of the surgery. Hyperpigmented, keloid, hypopigmented, textural, shiny, and linear scars on the upper lift can destroy the natural look of the upper lift, leading some patients to regret the decision to undergo the surgery in the first place. Dr. Karamanoukian is one of the leading experts in lip lift scar revision and can improve scar appearance and visibility with a combination of fractional lasers, IIT, topical therapy, microneedling, and non-ablative laser treatments. We see patients who have undergone lip lift procedures in Beverly Hills and Los Angeles, as well as those around the country. If you have undergone a lip lift, now may be the time to improve your lip scar with minimally-invasive options. 



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