Scar Revision Treatment | FAQ with Dr. Scott Hultman

Scar Revision Treatment | FAQ with Dr. Scott Hultman

(instrumental new age music)>>Scars are an abnormal
response to healing, either after an injury or surgery, for example, with an incision. Scars, however, may heal abnormally and cause symptoms like itching, pain, thickening, or tightness. Therefore, managing these scars correctly is very important so that we can improve our outcomes for our patients. One of the things that we focus on is how does the skin heal and how can it be rehabilitated after this type of injury or incision. Therefore, the overall
outcome is dependent on interventions that we may do
after an injury or a surgery. (instrumental new age music) Scars can be managed both
surgically, but also medically. It’s important to note that there are many noninvasive ways that we can treat a scar. The simplest, perhaps,
is massaging the scar to remove some of the extra
swelling that is present. Also, scars need to have
moisturizing agents applied, as well as sunblock to help
prevent pigmentation changes. However, scars can become
thicker, as well as tighter, and can contract or shorten. To address this, one of the
first things that we recommend is using silicone sheeting which helps to soften up the scar a little bit. (instrumental new age music) About 10 years ago, we
realized that different lasers could be utilized to help treat scars, especially the abnormal scars that form after injury or surgery. The scars actually target
different components of the scar that are abnormal, so rather than excise
the scar with a scalpel, we have found that the
scars can be rehabilitated. That is, we can actually address some of the abnormal
properties of the scar. For example, a pulsed diode laser is used to decrease the inflammation by, essentially, cauterizing
some of the small blood vessels that keep a scar inflamed. Another technology that we’ve
used for the last 10 years is fractional carbon
dioxide laser resurfacing. This particular laser
targets water that collects within the swollen scars
and vaporizes that tissue. What’s vert interesting is that the scar itself will remodel into a more natural scar than what the patient
may have experienced. The fractional CO2 laser sets the stage for the scar to remodel
and actually regenerate some of the abnormal or
missing elements of the skin. (instrumental new age music) Prior to the introduction of lasers, we would tell patients they would require multiple surgeries to
address their abnormal scars. With the advent of laser therapies though, we are able to modify the skin, sometimes without the need
for any surgery altogether. This is really an exciting new development that has occurred just
within the last few years. Lasers will help us to
reduce the need for surgery and sometimes eliminate
a procedure altogether. A good example would be a
patient who has a contracture over a joint or a shortening of the skin. In the past, we might
have to put a skin graft or even bring other tissue
in to resurface that area. Now, with the use of lasers, we can decrease the need
for that reconstruction, shorten the procedures, as
well as the recover time, and sometimes even eliminate
surgery altogether. (instrumental new age music) One of the great things
about user lasers now for reconstruction is that this has greatly reduced the need for
admission to the hospital. Lasers themselves do hurt quite a bit and we do need to use general anesthesia or some type of deep sedation, but these are very quick procedures, extremely safe, and are
done on an outpatient basis. Sometimes, however, when we combine a laser procedure with a
surgical reconstruction, admitting the patient
overnight is helpful. (instrumental new age music) Recovery after laser treatment depends on the total area that we treat, as well as the type of laser that is used. The pulsed diode laser
feels like a rubber band being snapped on your skin, which, of course, is not very comfortable, but if we have to do
this over a large area, we do need to have some
sedation for the patient. However, afterwards,
the patient feels like they’ve got a minor bruise to that area. The fractional CO2 laser
does hurt quite a bit as this is an invasive laser that actually causes
vaporization of the tissues. One usually has a little bit
of stinging for about 24 hours, but in general, patients can get back to school and work and to social functions within a couple of days. (instrumental new age music) Health insurance does
cover most scar revisions, whether it be through an open surgery or through laser modification of the scar. We look at scar revision as
a reconstructive procedure. We are reconstructing form
and function of the patient. There are some aesthetic
or cosmetic benefits, but there are also a number
of functional benefits that the patient will experience. These benefits include
reduction in pain and itching, but also improved mobility
and range of motion of joints, for example. So, most insurance companies
will cover laser surgeries and other scar revisions, but there is a pre-authorization process that does require documentation that there is a limitation
in form or function. (instrumental new age music) Johns Hopkins is really
an ideal place to come for scar revision and
treatment for many reasons. First, we’ve got a very
caring and experienced team who understand the patients, their needs, and their goals for treatment. Secondly, we have access to a wide array of state-of-the-art laser
equipment and technologies to help us treat these scars. And third, we have many
dedicated professionals who have expertise in physical therapy, occupational therapy, and pain management, all of which are combined to
help take care of our patients. (instrumental new age music)


  • Kenzo GamerTv says:


  • M Smith says:

    Can you recommend someone in Los angeles


    Scars remove cream name

  • khan Rana says:

    I had mole got it reemoved by e cautry but after it developed hypertropic scars then dermatologist gave steroid injections .what happened surrounded skin turned very light ?? Too worried what to do

  • pawpatrol fan says:


  • Morris Mpapele says:

    Average cost ???

  • Morris Mpapele says:

    Does it work with acne?

  • Mr TATTAGLIA the pusher man says:

    I had a small case of Mrsa in my face an my whole face feels swollen an my skin color is white an I’m brown how do I get my color back

  • shakila nana says:

    Where are you located??

  • Terrian Williams says:

    What about a tattoo scar?

  • Vilma Cisneros says:

    I have a burn scar, and i need to know more information

  • Radostina Racheva says:

    I have a scar on my face(between my eyes close to my right eyebrow).It a line(lither then the rest of my face).I got it when I was 5.Now I'm 20.I hit my face.Is it possible to remove it?I really hate it.

  • Edoardo Cetronio says:

    How about transplant scars? I have one in the back of my head with fue hair graft in it

  • Sapi147 says:

    Il trying to find if you can have plastic surgery to ADD a scar

  • cherry blush says:

    sir I hd a mrk on d center of my nose..nd I did small surgery to remove dt mark 5 years bfr..nw dt area luks more darker as im very there any solution to make it light?..

  • Omar Shah says:

    I Need your help Doc

  • Joab Simiyu Pasliano says:

    hey Doc i have unstitched scar on my eyebrow how can i remove it any help plzzz…

  • Joab Simiyu Pasliano says:

    hey doc am in kenya kindly help this car irritates so much

  • dan deng says:

    Very clear and will read more.

  • Maria Dina Titoy says:

    Hi Doc.. Good Evening from here in the Philippines I just wanted to ask. If what is the best solution for my chickenpox scars this is been 10 years on my legs..

    Thank you hope to hear ur response Doc,. GODBLESS YOU!

  • mohsin pervaiz says:

    Lip Doctor, Non-surgical cosmetic treatment Services..Dr. Bector and his team provides Scar treatments to their customers at their clinic in Canada.I will highly recommend their services.They provide high quality services at reasonable packages.Scars are unfortunately, a natural part of our body’s healing process.People develop
    visible scars on the skin when the biologic process of wound healing patches together damaged tissues with a strong, fibrous network of collagen.

  • Bhlessie Abarquez says:

    Goodevening doc…i'm from the philippines i just want to ask what is the best solution for my old scar to remove it?..

  • Marquina Family says:

    I have a nose scar from over 8 years from when I hit my nose to a chair I want to remove it and if I 100% can’t Can I make show a lot less please help and give me advice!

  • Dina Deng says:

    I got a breast lift and i got the Anchor stitches – i have a keYloyed scar all over the anchor under the breast what would help me get rid of it HELP!

  • 파크사라 says:

    What product is good to scars at my leg

  • Rica Capaycapay says:

    Hi doc/anyone who knows how to remove scars . I have scars for 6 yrs and its dark , can anyone how to remove these scars? because i cant wear shorts even at home because i have scars in my knee🙁

  • Clarence Nolin says:

    Where can I go for later treatment my scars won't fade …what is the best product doctor???

  • Lian Paulo-Corpuz says:

    From where are you sir? Can you recommend here in taiwan?🙂

  • lilxbwnsuga says:

    I was very fortunate to have a successful surgery as a baby for bilateral club feet. I’m in my 40’s now, but I’m reminded everyday of the scars. Is there any hope to make them less visible? I want walk bare leg on the beach before I die without people staring at my scars.

  • Laurence Valmoria says:

    Hello. Good day. Is there any clinic available you outsourced in Cebu??

  • Joseph McDonald says:

    This acne guide “Kαtοnοz tdα” (Google it) was surprisingly straightforward and practical in it`s way of taking feasible steps to get rid of the elements that attribute to acne. I have suffered acne issues for quite some time now and I am excited to give the ideas in this guide a try. I will share this helpful guide to my buddies. .

  • Mina30000000 says:

    I have the word "trash" carved on my thigh. Should I just burn it with hot metal so it doesn't look like I deliberately harmed myself? A large burn would be more socially acceptable. I was intoxicated when I did this to myself. I don't usually cut myself.

  • Jordyn Turner says:

    What can you do for skin graft scars??

  • linda smith says:

    Hi doc first i wanna thank you , i have a question please answer me

    At any age we can be allowed to use laser treatment

  • Maira M says:

    Laser treatment and PRP are becoming increasingly important in healing scars quickly and naturally, without the need for any kind of surgery. For anyone interested in getting scar treatments in Toronto and Mississauga, check out Dr. Neel Bector's excellent work here:

  • Baishali Dev says:

    Can anybody help me removing my self harm scar which is around 8 years old..

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