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4 Injections to Treat Scars

Blog post - photos scar plastic surgery cosmetic face hypertrophic steroid 5FU hyaluronidase

Before and after scar tissue in the chin treated with injection by Dr. Chaboki. Initial chin surgery performed by another surgeon.

Wrinkles, puffy eyes, and loose skin are only part of a plastic surgeon’s day in the office. Scars and scar tissue also play a role in every plastic surgeon’s practice spectrum.

Every surgery, and many nonsurgical treatments, will have scar tissue. Some patients are predisposed to scarring. Plastic surgeons offer these injections both to prevent and minimize scars and to treat scar tissue that has formed in appropriate patients.

The primary methods to treat scars with injections include

  • steroids
  • 5FU
  • hyaluronidase
  • filler

Injections can help flatten, thin, and fade scars to improve the appearance, soften scars to reduce tethering or restriction of adjacent tissue, fill depressed scars, and decrease symptoms of itching, irritation, discomfort, and redness of scars.

Steroid Injections for Scar

Steroid injections are the most well known nonsurgical option in scar treatment. The main steroid in plastic surgery offices is triamcinolone (Kenalog®), which comes in different concentrations.

Based on the body area and nature of the scar itself, steroid injections may be performed once or over a period of time. Patients who may need multiple steroid treatments, then injections are spaced several weeks apart to allow the medication to slowly help reduce scar tissue.

Examples of steroid injections include prevention of scars in Asian upper eyelid surgery and to improve definition of the nose after rhinoplasty.

5FU Injections for Scar

5FU (5-fluorouracil) has long been used as a chemotherapy drug to treat cancers. Plastic surgeons use 5FU as injections to treat scar tissue, similarly to steroid injections. 5FU may be used as an alternative or combined with steroids as appropriate.

Examples of 5FU injections include treatment of scars and nodules after fat transfer or to reduce scar tissue after facial filler injections.

Hyaluronidase for Scars

Hyaluronidase is an enzyme that is normally found in our skin, which has been synthesized and available for injection. Hyaluronidase injections are considered very safe and have been used for many years. Hyaluronidase is well known in cosmetic surgery to reverse certain facial fillers (ex. Juvederm®, Restylane®, Belotero®).

The technique of hyaluronidase treatment is similar to steroid and 5FU injections. A small needle is placed in the area of the previous HA filler or scar tissue for injection. Many patients don’t require pretreatment numbing. Bruising or swelling is typically mild and short-term. Read more about hyaluronidase to reverse facial filler injections.

Blog post - photos scar plastic surgery cosmetic face hypertrophic steroid 5FU hyaluronidase

Scar tissue behind the ear after otoplasty surgery by another surgeon, referred to Dr. Chaboki for treatment.

Facial Filler for Scars

Facial fillers work completely differently as compared to other injections for scars. Fillers are soft gels injected into the skin and tissue to add volume. Facial fillers allow a surgeon to sculpt and contour the face and skin. Fillers are more commonly known to enhance lips and cheeks, but also an options for scars too.

Examples of filler injections for scars include acne scar treatment or depressed scars from fat atrophy.

All treatments, including nonsurgical injections, may have potential side effects. Steroid injections, 5FU, and hyaluronidase may contribute in skin color changes (ex. hypopigmentation), redness and inflammation, and tissue atrophy (ie. sunken or depressed area).

Keep in mind that results with these injections may not occur immediately, but rather develop gradually over time. In addition, combined treatments or multiple treatments may be necessary for significant scars. Lastly, plastic surgeons cannot remove scars, but rather may be able to improve scars.

Speak with your plastic surgeon if nonsurgical injections would be appropriate for your cosmetic surgery. Dr. Chaboki sees patients who are referred him to help treat scar tissue after cosmetic surgery.

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    Houtan Chaboki, M.D.