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Scar Revision
Scar Revision: Beverly Hills and Santa Monica Plastic Surgery for Scars

Treatment of Scars on the Face and Body:


Every scar can be improved with laser. Plastic Surgeon Dr. Raffy Karamanoukian provides the top scar treatments in Los Angeles for scars, keloids, and hypertrophic scars. 

There are different types of scars that can occur on the face and body.  Most scars are caused by trauma to the skin or surgery.  Skin specialists classify scars based on their thickness and level of skin discoloration.  Scars can be treated using several effective methods that are chosen based on whether a particular scar is darkened, thickened, or widened.  In our Los Angeles office, scar revision is performed using the Pulsed Dye Laser, Yag laser, topical creams such as Melaquin PM, subcision surgery, or scar excision and revision. Some deeper scars can be corrected using fat grafting or Juvederm injectable fillers. 

scar revision los angeles


The development of scars is inevitable after skin or tissue injury.  The body naturally tends to heal the wound by depositing collagen and elastin, creating a seamless scar in the process.  Under certain conditions, the environment for healing is not necessarily ideal, such as after trauma, infection, or prolonged inflammation. These factors can cause a scar to be less than ideal in size, shape, and color.  If you are not pleased with the type of scar you have, you should consider a consultation with Dr. Raffy Karamanoukian for scar revision.  During your consultation in Santa Monica or Beverly Hills, you will be explained your options including scar revision surgery, chemical peels, topical treatments, or laser scar removal.  Call our office at (310) 998-5533 and speak to one of our plastic surgery patient care coordinators to schedule a consultation for Los Angeles scar revision.


Patients are often very concerned about the development of keloids or hypertrophic scars.  Which leads to the question: What is a keloid scar? A keloid is caused by an overgrowth of collagen by overstimulated fibroblasts in the skin.  The result is an inflamed scar that is steadily growing beyond the limits of the skin.  A hypertrophic scar is less inflamed and does not grow above the skin, it just seems to widen and thicken.  If you have a tendency to develop keloids in your family, you may wish to discuss all of your options with board certified plastic surgeon Dr. Raffy Karamanoukian. 


scar revision los angeles


There are many aspects of active scar treatment that can improve scar formation and minimize the severity of a particular scar.  Dr. Raffy Karamanoukian is a leader in the field of hypertrophic and keloid scar treatment and can help you minimize scar formation in the early phase of scar healing.  If you are concerned about scars that have already developed, Dr. Karamanoukian can evaluate your current scars and help you formulate a treatment plan that incorporates laser, surgical, and topical scar regimens. 


before and after keloid  before and after keloid scar


A scar, once formed, is permanent. However scars may be made less visible and more acceptable by surgically rearranging and/or relocating them, which also improves functional deficits, thus improving appearance, confidence and self-esteem. Our office is the leading scar treatment center in the United States. Dr. Karamanoukian uses a combination of state-of-the-art lasers, RF treatments, ablative treatments, non-ablative treatments, injections, and scar modulation protocols to help improve your scars. The type of treatment you will need for your scars is dependent on which of the following categories define your problem:

  1. Hyperpigmented Scars
  2. Depressed Scars
  3. Thickened Scars
  4. Widened Scars
  5. Keloid Scars
  6. Acne Scars

There are many options for scar revision available in our Beverly Hills Plastic Surgery office, including surgical excision of scars, laser scar removal, chemical peels, scar subcision, topical treatments, injectable IIT and TAC, and combination scar treatments that employ multiple modalities for scar revision in a staged fashion. Some patients will opt to undergo no surgery and instead, choose a combination of Kenalog injections, laser therapy, and pressure management.  Thick scars and keloids do well with kenalog injections and pressure treatment, coupled with laser therapy.  Depressed surgical scars will respond well to percutaneous scar release and scar revision surgery. 

keloid pics on ear

The goal of scar treatment for acne scars and depressed scars is to build new collagen at the scar base so that the skin depression can be filled naturally and recontoured.  The stimulation of collagen and elastin is performed through scar subcision, scar surgery, or laser scar revision, all of which stimulate scar fibroblasts to produce collagen in the designated area of scarring.  After the collagen is built, the scar resumes a normal contour and configuration relative to the surrounding tissue. 


There are many reasons why patients choose to undergo scar revision.  Scars can occur on any part of the body as a result of trauma, surgery, accidents, and acne.  Scars can be permanent as a result of a violation of the dermis and deeper layers of the subcutaneous tissue.  As a result a scar may develop that influences the overall contour of the soft tissue.  Scar revision techniques include laser, chemical peels, dermabrasion, subcision, or electrodesiccation.


Dr. Karamanoukian performs treatments for keloids and scars by surgery, kenalog injections, and laser keloid treatment


Scar revision of face – Scars on the face are usually a result of an accident, trauma, or acne scars.  Acne scars represents the majority of scars that occur on the face, and are often very difficult to treat.  Dr. Karamanoukian is an expert on acne scar revision and employs many modalities to treat acne scars including punch excision, subcision, chemical peels, or laser.  The decision to pursue acne scar revision depends on the depth of the acne scar and its location.  Acne scars on the nasolabial fold, cheek, temples, often yield superior results to acne scars on the nose and forehead.  However there are many options to treat all types of acne scars.


There are many different types of scars that occur on the face.  One of the most prominent areas of facial scarring is the forehead, which represents a broad area of skin that is vulnerable to trauma and to traumatic lacerations.  The forehead is defined on the upper aspect by the hairlines and by the lower aspect by the eyebrows.  The patients often presents to our Los Angeles plastic surgery office with complaints of forehead scars that are resulted from acne, chickenpox, or scars.  These three causes represent the most common pattern of scarring along the forehead.  Dr. Raffy Karamanoukian is a double board certified plastic surgeon who specializes in scar revision, especially with scars on the forehead.  Management of scars can include surgical reexcision and layer closure, laser surfacing, retexturization of scars, facial peels, and dermabrasion.  By using a combination of techniques, Dr. Karamanoukian can improve the quality and appearance of a scar in order to make it less noticeable on the forehead.  Facial scars represent a major surgical challenge for plastic surgeons to improve scarring and to decrease the visibility of a particular scar.


There are many aspects of a forehead scar that can be addressed with scar revision techniques.  Scars can be atrophic, hypertrophic, pigmented, or red.  These visible aspects of the scar can detect the type of procedure and the order with which surgical scarring on the forehead is corrected.  Atrophic scars include acne scars and chickenpox scars which damage the dermis and causing indentation in the skin.  Hypertrophic scars are caused by an increase in collagen scar formation with resultant widening and thickening of a scar.  Hypertrophic scars are often associated with active inflammation or redness, which must be controlled prior to scar revision.  Pigmented scars and discolored scars can occur as a result of postinflammatory hyperpigmentation or discoloration of an incision or laceration during the initial phase of wound healing.  Finally, some scars may be red and inflamed with micro blood vessels that cause a scar to be reddish in appearance and hypervascular.


Management of forehead scars beings with a careful examination of the scar to determine the type of scar that exists on the skin.  Atrophic and hypertrophic scars are treated differently, with a combination of scar surgery techniques, scar excision, layer closure, laser therapy, and dermabrasion.  These types of techniques are used in combination and are carefully tailored to a specific need in order to improve the scar.  Not all scars will require surgery, but scars that are indented are linear may benefit from surgical excision of the old scar with layer closure and scar revision.  Acne scars and chickenpox scars are among the hardest forehead scars to treat.  They often represent atrophic scars with loss of collagen in the dermis.  Treatments for chickenpox or acne scars depend on the severity of scars and the number of scars present.  Scar excision and subcision can both be used to improve the contour of a scar and the overall texture.  In addition, discolored scars can be treated with a combination of facial peels and topical deep pigmenting peels that can lighten skin tone and even out skin color.  The Melapeel is an ideal facial peel for discolored scars that are darker than the surrounding skin.


Reddish scars are caused by hypervascularity and broken blood vessels within the scar tissue.  These scars can become red with increase in temperature, anxiety or blushing.  Treatment of the redness can often camouflage a scar make it less visible compared to the surrounding tissue.

In the case of red scars, Dr. Karamanoukian will employ a pulsed dye laser to treat the scar and make it less noticeable.  The pulsed dye laser is a goal standard in scar management as well as removal of reddish discoloration.


Linear scars and hypertrophic scars that are either indented or thickened may benefit from a scar revision technique known as scar excision and layer closure.  In this scar technique, the old scar is excised and the new incisions lines are then repaired in order to minimize scarring and break up the linearity of the scar.  Dr. Karamanoukian may also opt to perform Z plasty, Y Plasty, or other scar minimization techniques in order to break up a visible scar.  Plasty techniques are often referred to as geometric scar revision, because geometrically-designed skin flaps are used to reduce tension and rearrange scar tissue. 


Dr. Karamanoukian is an expert in scar management and scar revision and is a double board certified plastic surgeon practicing in Los Angeles.  For a complete list of procedures performed by Dr. Karamanoukian or to learn more about scar revision techniques for forehead scars, please schedule an appointment with Dr. Karamanoukian today.  Call 310-998-5533.


Cheek Scars: Scars on the cheeks can cause embarassment and social anxiety, particularly because the cheeks are such a noticeable part of the face.  Traumatic facial scars are usually caused by a laceration or cut in the skin, often resulting in thickening of the scar, widening of the scar, hyperpigmentation, hypopigmentation, depression of the scar, or a combination of problems.  Dr. Raffy Karamanoukian can help you manage your facial cheek scars using a combination approach that can dramatically improve scar visibility and help you improve the cosmetic outcome after trauma. If you have been in an accident and wish to learn about your options, please call our office to schedule a consultation for scar revision with Dr. Karamanoukian. 


Forehead scars: Forehead scars are most commonly caused by accidents or falls that result in a break in the skin requiring sutures.  Scars can be refreshed and revised using a combination of scar revision techniques that are ideal for forehead scars and facial scars.  Usually these scars follow a pattern of poor scar formation including hypopigmentation, depression of scars, and visibility of scars along the edges.  If you live in the Los Angeles area and are considering scar revision for a traumatic forehead scar, you may be a candidate for a combination of laser, scar revision surgery, and subcision to repair your scar.  Dr. Raffy Karamanoukian is a double board certified plastic surgeon and an expert in scar revision surgery.  He has performed countless lip scar revisions, facial scar revisions, keloid revisions, and forehead scar revisions in his Los Angeles plastic surgery practice.  Procedures usually are performed on an outpatient basis and can improve the overall quality and visibility of your scare in as little as one session.  If you have questions about scar revision and forehead scars, please call our Los Angeles plastic surgery office at 310-998-5533.


If you have been in an accident or have suffered an injury in which you developed a forehead scar, you may be a candidate for a combination scar revision regimen that can either eliminate or improve the visibility of your scar.  Forehead scars can be particularly troublesome for patients as they represent a deformity in a very visible and exposed area of the face.  Unlike other parts of the body, the forehead is a relatively flat area that can be dramatically changed by the presence of a linear or stellate scar.  Most scars that form on the forehead show up as a linear hypopigmentation or hyperpigmentation coupled with either a raised scar or a depressed scar.  There are many options available for scar revision, including laser scar treatment, dermabrasion, subcision, and scar revision surgery.  One of the most knowledgeable and experienced plastic surgery experts in the Los Angeles area is Dr. Raffy Karamanoukian, a board certified plastic surgeon who specializes in cosmetic plastic surgery and scar revision surgery.  Dr. Karamanoukian can approach your scar using a multi-pronged approach that minimizes recovery and maximizes outcome after treatment.  Call 310-998-5533 to speak to our Los Angeles plastic surgery patient care coordinator regarding your surgical and nonsurgical options for scar revision.  If you are traveling from out of the country or outside of the Los Angeles area, Dr. Karamanoukian can provide specific treatment protocols that can work alongside your travel arrangements. 


Acne scars: Patients who have acne scars are often uncomfortable with the appearance of the scars under various forms of light.  Acne scars can become more noticeable as a result of skin wrinkling, skin edging, hyper or hypopigmentation, exposure to the sun, and progressive scar formation.  Often, the eruption of cystic acne can come all at once and cause acne scars to form in clusters all over the forehead, cheeks, mid face, and neck.  These acne scars can often be dark in color, irregular in shape, thickened, or hollow.  The two most common types of acne scars that are found in our Los Angeles plastic surgery office are atrophic acne scars or dark acne scars.  Some patients also have large chickenpox scars that may also be similar in appearance to acne scars, presenting with pigmentation or hollowing of the skin. 


Of the many treatments available for scars, there is no single one treatment that is suitable for all acne scars.  Acne scars vary in terms of their depth, width, shape, and color; and all benefit from various different acne scar regimen.  The most important first step in diagnosing and treating your acne scars is to visit the office of a board certified plastic surgeon and skin specialist who can decide which treatment option is best suitable for your specific acne scar problem.  In the Los Angeles area, Dr. Raffy Karamanoukian is one of the most prominent acne scar specialist and scar revision specialist in the region.  He has given lectures on the topic of scar revision and has appeared on popular television shows demonstrating his unique approach to scar management. 


In our Los Angeles office, we offer laser, subcision, acne scar treatments, and chemical peels to remove or improve acne scars.  These treatments are often used in combination to improve the overall quality of the acne scar and improve the skin on the face.


Acne scars can occur on the face, neck, chest, and back.  In diagnosing an acne scar, our office, first evaluate the thickness of the skin and the inherent loss in dermal collagen that has resulted from the cystic acne.  Most scars will follow characteristic patterns of scar formation and can be improved with simple outpatient procedures that build collagen, release scar tissue, decrease pigmentation, and improve skin tone.


Acne scars begins with a consultation with board certified plastic surgeon Dr. Raffy Karamanoukian.  During your consultation, Dr. Karamanoukian will evaluate your skin tone and determine whether your scars are a result of atrophy, thickening scar formation, keloid development, hyperpigmentation, or hypopigmentation.  Based on your skin complexion, skin tone, amount of sun damage, and severity of your acne scars, Dr. Karamanoukian will determine what options are available.


Two of the most innovative advancements in acne scar treatment include sublative and ablative treatments. EMatrix is a revolutionary sublative treatment that improves contoured and atrophic acne scars with minimal downtime and recovery. Patients require several sessions in order to improve surface texture, surface contour, and visibility of acne scars. Fractional CO2 laser is also used in our office to recontour and retexture acne scars on the surface of the skin. Fractional CO2 provides dramatic improvements in the skin and can improve visible acne scars. 


A new non-laser acne scar treatment is the Ematrix sublative system that relies on revolutionary fractional RF to stimulate collagen and reduce contour irregularities in the skin caused by atrophic acne scars. Ematrix can be used on valley scars, box car scars, indented scars, and ice-pick acne scars. 


Acne scars can also be hyperpigmented and these scars can be treated appropriately with topical skin care creams, chemical peels and laser therapy.  Hyperpigmented acne scars can qualitatively be improved with a combination of treatment modalities that are used in Los Angeles office. Pigmentation of dark acne scars are treated with either Melarase creams or Plato's Medicinals Dark Scar Corrector. Both of these products eliminate dark acne spots by lightening the abnormal skin discoloration. 

Atrophic ice-pick acne scars can also be treated with TCA-Cross chemical peels that use a highly concentrated form of TCA acid to stimulate new collagen production within the ice-pick scars. TCA Cross takes several days to heal and patients may require more than one procedure to reduce the appearance of ice-pick scars. 

For a more comprehensive treatment plan for your acne scars we recommend consultation in our Los Angeles office by calling (310) 998-5534.


Breast scars – Breast scars usually occur as a result of surgery including breast implant surgery, breast reduction surgery and breast lift surgery.  In addition, some patients may develop breast scars as a result of breast reconstruction arising from breast cancer surgery.  Patients with lumpectomy, mastectomy surgery can have permanent scar deformities on the breast.  Dr. Karamanoukian is an expert on breast scar revision and uses a combination of pulse dye laser therapy, scar revision, surgical excision, and laser treatments to improve scars.  The patients who have defined scars from breast reduction or breast lift procedures may benefit from surgical scar revision.  Many of the scar revision techniques can be performed in an outpatient setting in our Los Angeles office or surgical center.


Areolar scars and breast augmentation scars on the inframammary fold can often become noticeable as a result of thickening, discoloration, and widening of a scar.  Thick keloid scars and hypertrophic scars of the areola can benefit by a combination of IIT, cortisone injections, pressure treatment, and laser therapy.  Widened scars that are red or discolored in appearance also benefit from combination pulsed dye laser and Melaquin PM creams used twice daily.  Our expertise lies in making your breast scars less noticeable and less visible.


Accident scars – Accident scars can occur as a result of trauma and includes contour irregularities, depressed scars, pigmented scars.  These scars occur as a result of the accident itself or as a result of the surgical repair of a laceration or injury.  If you have a noticeable scar as a result of trauma or suture repair of a traumatic laceration, Dr. Karamanoukian can employ a variety of laser, chemical peel, dermabrasion techniques to improve the overall contour, shape, and visibility of the scars.


Belly button scars – Many patients have scars that arise from an old belly button piercing.  These scars can be improved using a simple surgical technique to excise the old belly button scar and resuture the scars to improve the look of the belly button.  This procedure is performed in our outpatient surgical suite in as little as 30 minutes.  The results are instantaneous and complete healing is obtained within a matter of few days.  If you have a belly button scar as a result of a tummy tuck or belly button piercing, we advise you to consult with Dr. Karamanoukian to obtain a definitive surgical plan.  Laser treatments of the scars can also improve the overall texture and feasibility of the scar.


Cheek scars: Cheek scars can be very obvious because the scars occur on a very visible part of the face.  The convex nature of the cheek area makes the dynamics of scar production more difficult for the body, often resulting in scars that are depressed, indented, or variably different in contour.  The majority of cheek scars that we see in our office occur as a result of cystic acne.  Pustular cysts caused by acne can often cause atrophy of the dermis, resulting in pockets of indented skin throughout the cheek area.  These indentations can cause significant changes in the texture of the skin, coupled by contour problems, hyperpigmentation, and persistent redness.  The treatment for acne scars of the cheek are many, and differ in terms of whether the goal is to build collagen or improve texture of the skin.  Acne scars that are red can be treated with the pulsed dye laser, or V-beam laser available in our office.  This vascular laser can reduce redness, but usually require more than one treatment.  Atrophic acne scars that are known as valley scars, boxcar scars or even ice pick scars can be treated with a number of acne surgery techniques that act to build collagen.  In doing so, acne surgery can even out the contour of the skin much better than laser treatment.  Acne scars that are discolored or brownish in color can also be treated effectively with IPL and topical application of retinoic acid and Melaquin AM and Melaquin PM.  The discoloration can further be improved by the application of a chemical peel treatment known as the Melapeel.


There are many different types of acne scars that occur on the cheeks, including valley scar, ice pick scars, and boxcar scars.  Subcision is suitable for valley and boxcar scars, but is less suitable for the ice pick scar that occurs on the T-zone and central face.  Ice pick scars do well with TCA-cross techniques and punched grafting.


If you have cheek scars that are caused by trauma, such as scratches or burns or lacerations, Dr. Karamanoukian has specific options to improve your skin.  These options can resurface indentations and depressions in the skin and reduced redness and textural changes.  The textural changes that occur with cheek scars include a shininess and looseness of the skin that can be improved, but no eliminated, with laser skin resurfacing.  The laser of choice for Dr. Karamanoukian is the fractional CO2 laser that can retexturize the skin.


Ear helix scar - The helix of the ear is the outer semicircular rim of the ear that is composed of cartilage and overlying skin.  Helix scar can occur on the outer helix as a result of ear piercings that have become more and more common in the last decade.  Some of these ear piercings cause hypertrophic scarring and other cause early or severe keloid scarring wherein the keloid grows along the dermis and extends through the cartilage of the ear.  Many of these ear helix keloids are referred to as a “dumbbell” keloid because they resemble old fashioned weights that were previous known as dumbbells.  The treatment of keloids of the ear helix is relatively straight forward and most of these keloids are responsive to surgical excision and definitive closure.  In the recovery period, Dr. Karamanoukian will recommend a specific postoperative regimen which is composed of combination laser and IIT.


Earlobe piercing scars – Earlobe piercing scars are very common in the United States and occur as a result of traumatic pierce to the earlobe or as a result of erroneous piercing.  These piercing can be improved using a combination of techniques including scar revision, surgical scar revision, laser treatment, chemical peeling.  If you have a piercing scar on the belly button, earlobe, or any other area of the body, you may be a candidate for scar revision of your piercing.  Dr. Karamanoukian performs outpatient earlobe repair in an accredited operating room under local anesthesia.  If you are concerned about torn or split earlobes, Dr. Karamanoukian can provide you with many options for treatment. 


Tummy tuck scars – Tummy tuck scars are very common and result from a tummy tuck or abdominoplasty surgery.  These scars may be pigmented, thickened, or depressed in nature.  Surgical scar revision, laser treatment, and chemical peeling may improve the overall contour of the surgical scar.  The overall results can be dramatically improved with tummy tuck scar revision.  In certain cases Dr. Karamanoukian may also revise the abdominoplasty altogether to improve the contour of the area and recreate a beautiful contour to the waist. Dr. Karamanoukian has been featured as a tummy tuck scar revision expert and a belly button scar revision expert on popular websites and in the media.  Tummy tuck scars that are thickened, widened, or abnormal can be dramatically improved with a combination of laser scar revision and surgical scar revision. 


Bad plastic surgery scars – In some cases patients may develop noticeable scars from a particular plastic surgery procedure, that are traumatic, reconstructive, or cosmetic in nature.  If you have developed a thick, depressed, pigmented, or inflamed surgical scar from your plastic surgery procedure, you may be a candidate for surgical scar revision with Dr. Karamanoukian.  The consultation will be held in strict confidence and Dr. Karamanoukian will provide you with specific recommendations to improve your plastic surgery scar.


Chemical peel scars - Some patients who have undergone a chemical peel or laser peel without physician supervision may develop scarring on the face or permanent skin discoloration as a result of a chemical peel burn or a laser burn.  New topical treatments, followed by intensive ancillary treatment with a MelaPeel, may improve these scars and minimize the longterm effects of skin injury or burns.  Dr. Karamanoukian can provide you with specific details regarding the MelaPeel protocol for post inflammatory hyperpigmentation.  Patients should begin using the Melarase topical program as early as possible after the skin burn in order to minimize post inflammation hyperpigmentation and discoloration. 


Keloid Scars: Although keloid scars are most commonly associated with African-Americans, Pacific Islanders, and those of Asian descent, keloid scars can occur in any ethnic group.  The most common areas of keloid scar formation are on the earlobes and chest, but keloids can occur on the extremities, back, legs and thighs, pubic area, scalp, face, jawline, and chest.  Keloid scars are usually associated with inflammation and can be pedunculated, nodular, flat, or linear. Depending on the severity of your keloid scars; the presence of medical symptoms such as pain, itching, or discomfort; the location of a particular keloid; and keloid thickness, Dr. Karamanoukian will recommend a specific treatment protocol to address your particular keloid scar.  Our unique approach minimizes recurrence rates and minimizes the need for invasive surgery. 


Liposuction scars: Liposuction yields excellent results in most cases.  Liposuction scars can occur as a result of hypertrophy, hyperpigmentation, discoloration, or keloid of the incision sites; or as a result of depressions and uneven contour in the liposuction areas.  Dr. Karamanoukian is an expert in liposuction surgery and can help you manage both your liposuction results and address the scars that are formed from the incisions.  Darkening of the scars and residual fullness can also be addressed with a combination of laser and scar revision procedures.  Our office also offers the Liposonix treatment in Los Angeles, which can eliminate unwanted fat on the abdomen and waistline without surgery. 


  1. Dark Liposuction Scars: Skin discoloration can occur on liposuction incision sites because of a process known as post-inflammatory hyperpigmentation. When the skin heals, the inflammatory cells stimulate melanocytes in the skin to produce extra pigment. When this occurs, the incision sites can become dark and discolored. The first-line treatment for dark liposuction scars should be to use a combination of Melarase AM and Melarase PM followed by twice daily application of Melapads. 
  2. White Liposuction Scars: Even more common than dark liposuction scars are hypopigmented and white scars. These scars tend to show even on fair complexions. When the skin loses all pigment, the scars look visible as white scars. The options available for the treatments of white liposuction scars include fractional co2 laser and scar excision. 

Mole removal scars - One of the most common types of scars that we encounter in our office is a scar on the arms, legs, back, and chest that has arisen from a previous mole removal or skin biopsy.  Shave biopsies and mole removal scars can be embarrassing and unsightly, especially in exposed areas of the body. Dr. Karamanoukian can not only improve the appearance of old acne scars and mole removal scars, but can minimize the chances of you developing a bad scar in case you need other moles removed.  During your scar revision consultation or consultation for mole removal, please ask us about the many options you have to minimize scarring.


Scalp scars: Scars that occur on the scalp  are often affected by two main issues: namely textural changes in the skin and hair loss. Usually the hair bearing areas of scalp tissue can become thickened or widened, leading to an irregular texture to the surface of the scar.  A secondary issue with the scalp scars is the absence of hair.  Although scalp tissue tends to heal very well, there is often a segmental loss of hair, known as alopecia of the scalp.  The treatment of scalp scars begins with a careful examination to determine whether the visibility of the scar is largely due to textural changes in the scar or solely as a result of hair loss.  Incisions made into the scalp or scalp lacerations resulting from trauma can damage oblique hair follicles, leading to an acute or subacute loss of hair.  For those patients with scalp scars with hair loss, the most ideal treatment is either permanent tattoo to camouflage the scalp tissue or follicular unit extraction, in which individual hair follicles are transplanted into the scalp scars.  Dr. Raffy Karamanoukian is an expert in scar management and scar revision techniques and can isolate specific problems with scalp scars in order to improve their overall look and visibility.  If you are concerned about scars on your face or scalp area, the most ideal option can be obtained with a comprehensive consultation for scar revision with board certified plastic surgeon Dr. Raffy Karamanoukian.




The most innovative approach to scar revision is the use of laser to eliminate surface irregularities and smooth the skin after treatment. Lasers utilize a technique known as selective photothermolysis, which works by directing a high intensity laser beam onto the skin to treat a specific tissue chromophore.  During your Los Angeles plastic surgery consultation with Dr. Karamanoukian, the features of your scar will be examined in order to determine which laser will work on your scar type. Our office has many types of lasers, each of which will target different elements of your scar.  The process of laser scar treatment may be used in conjunction with TAC injection, scar revision, scar modification, chemical peels, and topical creams.  Our office recommends the use of Melarase AM Daily UV Protect and Melarase PM as part of your regimen to improve  scar quality. Dr. Karamanoukian is available for laser scar removal by calling (310) 998-5533.

Laser scar removal can be used to treat the following types of scars: Acne scars, traumatic scars, plastic surgery scars, keloid scars, hypertrophic scars, pigmented scars, discolored scars, dark scars, lip scars, cleft lip scars, surgery scars, and burn scars. Dr. Karamanoukian will perform a complete examination and recommend a treatment plan that will maximize your results while minimizing downtime.  Laser scar removal can effectively improve the appearance of scars on the face and body. 


MEDICATIONS TO AVOID BEFORE SCAR SURGERY: Our office will give you a list of medications to avoid during your preoperative consultation.  A general rule of thumb is to avoid any medications that can significantly thin your blood and cause excessive bleeding during your surgery. The most commonly used medications that can affect your bleeding are aspirin, ibuprofen (or similar NSAIDS), Coumadin, warfarin, and Vitamin E supplements. You should try to avoid these medications for at least two weeks prior to surgery. If time does not allow you to avoid these medications for two weeks, discuss your specific situation with Dr. Karamanoukian. He will either suggest that you reschedule your surgery, or more often, he may proceed with surgery provided that the outcome can be attained safely. It is best to have an honest relationship with your surgeon, so always disclose the medications you are taking. Daily multivitamins with Vitamin E are generally safe to take before surgery. 



  1. SUNSCREEN: One week after your scar revision treatment, our office recommends complete avoidance of direct sun exposure and twice daily application of a sunscreen. We recommend the Melarase AM creams. You may purchase Melarase AM from our office during your treatment or thereafter on . Melarase AM contains SPF 30 combined with non-hydroquinone skin lighteners to enhance skin color and prevent skin discoloration. 
  2. PIGMENTATION CORRECTION: One of the most notable features of traumatic or burn scars is the hyperpigmentation and darkening that occurs in the skin. This is known as post-inflammatory hyperpigmentation (PIH) and can affect the cosmetic outcome of scar revision.  Treatment of pigmentation and scar discoloration begins with aggressive post-care use of a topical skin lightening agent.  Our office recommends the Melarase AM and Melarase PM creams to reduce hyperpigmentation associated with scarring. The creams work well as Hydroquinone and non-Hydroquinone based products to reduce overstimulation of pigment deposition inherent in traumatized skin.  If you are interested in a consultation for scar revision, you may consider beginning the Melarase protocol prior to your visit in order to maximize the cosmetic appearance of dark scars prior to your consultation. 

Melarase Tripack with Melarase AM, Melarase PM, and Retinoid Repair for dark discoloration of scars

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