This is the traditional method of scar revision. It essentially involves injecting local anaesthetic, cutting the scar out and re-stitching it neatly. There will be a healing response after this, during which period the scar will look red and raised again. However, over time, the idea is that the neat stitching will result in a better scar than was present previously.
The CO2 laser is the most aggressive laser available for skin resurfacing. It works by burning the top layers of the skin off, which in turn generates a healing response. Traditional laser resurfacing burns the entire surface of the skin off. More recently advances in ‘fractional’ technology means that only a percentage of the skins surface is removed, using microscopic laser beams. This has the effect of still stimulating a healing response, but with a shorter recovery period afterwards. The CO2 laser we use is the CO2RE from Syneron-Candela, which has the ability to work in both full field and fractional mode. For treating depressed scars we normally use it in fractional mode, using a deep settings for the most effective results. The area will normally be red for a week or so afterwards. Normally a course of 3 treatments will be required.
This technique can be surprisingly effective at reducing the appearance of depressed scars. It does not take out the scar itself, but reducing the indentation behind the scar can have a significant impact in reducing the visibility of the scar.
This is an old fashioned method of skin resurfacing using a rotating wire brush. Due to the lack of control with this technique, the results can be unpredictable. There are few doctors who still practice this technique since the advent of laser technology.
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