Scars left behind from surgery, accidents, or medical conditions can serve as a constant physical reminder of personal trauma. As such, these scars can wreak a heavy emotional toll that impacts every aspect of daily life. Fortunately, there exists a wide array of surgical and non-surgical treatment options that can improve the appearance of these troublesome scars and relieve the associated distress.
Scar revision has been a particular area of focus for the entirety of Dr. Hooman Khorasani’s medical career. Besides having unique fellowship training in wound healing and scar repair, Dr. Khorasani has conducted clinical trials, published medical journals and written book chapters on these topics. From studying scars’ molecular structure to inventing new, innovative techniques, Dr. Khorasani has dedicated himself to helping patients overcome the heavy physical and emotional burden induced by their scars. Consequently, Dr. Khorasani has infused his practice with a broad range of cutting-edge scar revision therapies. The recommended treatment option is hand-picked for each patient based on the scar’s appearance, your unique health profile, lifestyle constraints, and your overall aesthetic goals.
After completing a year long research fellowship in scar management, Dr. Hooman Khorasani has spent the majority of his career cultivating expertise in improving the appearance of all scar types. Scar revision therapy is a staple of his practice and he is proud to have helped thousands of patients overcome their scars and, consequently, reinfuse their lives with self-confidence. His knowledge of scars extends beyond the revision stage, as his position as a dermatologic and cosmetic surgeon requires advanced technical proficiency to minimize scar formation following a procedure. Eager to mentor other health professionals so that they too can help patients, Dr. Khorasani has also published multiple studies evaluating scar composition, prevention, and management. This comprehensive and detailed understanding of the scar lifecycle allows Dr. Khorasani to provide you with cutting-edge, personalized therapy that maximizes scar correction.
You are unique and so is your scar. As such, we will work with your particular scar, skin type, health profile, and lifestyle constraints to find a treatment plan that is optimized to help you achieve your personal aesthetic goals. From the moment you contact our office, you are a priority. Dr. Khorasani and his staff are there for you at all times to ensure all your questions are answered and needs are met. We look forward to working with you as a team to transform your goals into reality.
Despite their bothersome appearance, scars are actually part of the body’s natural healing process. When the deep layer of your skin (the dermis) is damaged, your body produces new collagen to repair the wound. During this healing process, the body’s primary objective is to act as fast as possible to protect the surrounding structures and reduce the risk of infection. Additionally, the scaffolding required for normal collagen formation is damaged when the deep layer of the skin is injured. As such, the structure of scar collagen varies significantly from what is found in normal skin. These aberrations in collagen architecture lead to a markedly different appearance between the scar tissue and surrounding healthy skin.
Just as each person is unique, scars are also one-of-a-kind. There are, however, distinct categories of scars. Hypertrophic scars are those in which the body produced excess amounts of collagen in response to the injury. If the over-production of collagen extends beyond the boundaries of the original wound, the scar is then called a keloid. Scars that have caused the surrounding skin to tighten are called contracture scars. These are most often associated with burn injuries and can cause significant mobility problems in the area of trauma. Acne scars are the result of blemishes that have infiltrated the deep layer of skin, inciting the production of collagen. Unfortunately, patients often suffer from more than one category of scar; however, armed with over a decade of experience treating all scar types, Dr. Khorasani will be able to recommend the best treatment option for your individual scars.
All scars will exhibit some degree of redness during the initial healing phase. Most patients, however, will lose this red color over the course of six months to a year. Risk factors for persistent redness include having a fair complexion and/or sun exposure to the affected area in the early stages of your wound’s healing.
Over-production of collagen can lead to elevated scars that are thick and raised. This typically occurs in wounds that occured on the chest, shoulders, and upper back. Family history can also contribute to the formation of elevated scars.
Inadequate collagen formation can lead to scars that are sunken or atrophic in appearance. These depressed scars are typically associated with chickenpox and severe acne.
The rapid production of collagen during the wound healing process can result in ridges, pits, and bumps within the scar. Unfortunately, these texture abnormalities may sometimes be both palpable and visible.
The results of scar revision can vary, but most improve over time as the skin regenerates and as the result of multiple treatments. Good skin care regiments have also shown to improve results.
During your initial consultation, Dr. Khorasani will carefully evaluate your particular scar to discern its type and characteristics. Incorporating your personal aesthetic goals, health profile, and lifestyle constraints, Dr. Khorasani will recommend an individualized therapy plan that best addresses your specific needs.
Severe scars that have not or will likely not respond well to other treatments, may benefit from a surgical revision of the area. This in-office procedure is performed with local numbing medication and requires less than an hour to complete. Utilizing the experience from Dr. Khorasani’s decade-plus surgical career, he will develop an operative plan that best addresses your needs and optimizes the best aesthetic outcome.
Morpheus8 is our newest device that comes with various handpieces with up to 40 microneedles that can be used to stimulate collagen in various parts of the body. One of the main advantages of Morpheus8 RF Microneedeling is that it can be used on all skin types. This device is a popular treatment option for patients that have skin of color, as it avoids some of the risks associated with traditional laser therapy such as post inflammatory hyperpigmentation. Another advantage of Morpheus8 is the relatively low downtime and minimal wound care associated with this procedure. When it comes to scar revision, Morpheus8 is a fractional skin treatment that works to produce collagen in the dermis, in order to remodel the scar. This device allows Dr. Khorasani to have exact control over the depth of the needles, and choose the different depths of treatment. Collagen in the face and body are remodeled to help correct the appearance of scars. Morpheus8 can be used on any areas of the body that can benefit from better texture, tone and renewal. The most commonly treated areas include the face/neck, abdomen, back, buttocks, and legs.
The previous dogma was to allow six months for recovery before treating a scar. New research has demonstrated that earlier intervention of treating a scar is much more beneficial than waiting for an unknown outcome. We now know that infant scars are significantly more amenable to change than older scars. Therefore, in cosmetically sensitive areas we recommend that if possible, you start your scar treatment as early as six weeks after the initial event that caused the defect.
This depends on the type and severity of your scar, your skin color and the timing of intervention. A few examples are given below as a general guide:
The procedure experience varies according to each scar revision therapy. Patients undergoing laser resurfacing or microneedling treatments will be numbed prior to the procedure with a topical anesthetic cream. Laser resurfacing procedures may be associated with a warm or stinging sensation during treatment. Vbeam treatments have been compared to feeling as though someone is lightly snapping a rubber band against your skin. During a microneedling treatment, you may feel pressure-like sensations as the tiny needles target the scar tissue.
Dermabrasion and surgical revisions require the injection of a local numbing medication to anesthetize the area prior to treatment. During these procedures, you will not feel any pain; however, you may experience some pressure.
Both semi-permanent filler injections (Bellafill) and triamcinolone and 5-FU injections do not require any numbing beforehand, as you will only feel a tiny prick as the needle is inserted. Please note that prior to receiving treatment with semi-permanent filler injections (Bellafill) you will receive a special skin test to ensure you are not allergic to any of the filler’s contents. We then evaluate the skin test site at your next appointment to ensure there is no reaction to the medication. This measure to ensure your safety means that, unfortunately, we are unable to both test and treat you on the same day.
Other than safety, your comfort is our number one priority. If at any time during your procedure you are experiencing discomfort, please inform Dr. Khorasani and he will provide you with additional measures to ensure your comfort. These include our in-office Pro-Nox system which employs nitrous oxide (“laughing gas”) to reduce anxiety and the experience of pain. Pro-Nox can be self administered by you as needed to address any discomfort.
Scars often leave physical and emotional marks on a person, which may significantly impact their self-esteem. Helping patients eliminate this physical reminder of personal trauma is, therefore, one of Dr. Khorasani’s passions, as the benefits of this procedure extend far beyond the improved cosmetic appearance. No matter the size, location, or type of scar you suffer from, Dr. Khorasani will be able to suggest a treatment plan that is tailored to your specific needs. Rest assured that this recommendation capitalizes on Dr. Khroasani’s decade-long experience revising scars and has been hand-picked for you to provide the best possible outcome.
The best candidates for scar revision treatments are those with completely healed scars who are not currently sunburned or tan. Although smoking does not preclude you from receiving treatment, we strongly advise against smoking in the period surrounding your treatment in order to ensure the optimal healing and outcome. Patients with active acne or other on-going active skin problems in the scar area are not candidates for scar revision therapy. Patients on oral tretinoins such as Accutane should wait six months after discontinuation of these medications before starting scar treatments.
Dr. Khorasani and his highly-specialized team look forward to working with you to transform your medical or aesthetic goals into reality. To expedite a request for a consultation, message us securely, or contact Dr. Khorasani’s Manhattan office by phone at 212-230-3378. For more information about how to get in touch:CONTACT US