In the world of cosmetic surgery, sometimes less is more, and often a sense of beauty comes from solving a smaller, surface issue—fixing unsightly scars or discolored skin—rather than from reshaping a nose or breasts. In the case of scars, a patient is hoping not to augment their appearance but simply to reclaim it—to be made “whole” again.

Scar Basics

A scar is a natural part of the healing process, formed as new collagen fibers reconnect damaged skin and form a “seam.” Your options for getting rid of that scar depend on what kind you have.

Scar tissue “is basically made from collagen,” explains Dr. Edgar (“Eddie”) F. Fincher, who specializes in scar tissue removal at the Moy-Fincher Medical Group in Beverly Hills, CA . “It’s laid down by your body in response to, and healing from, acne, or whatever injury you receive.”

Of all the scars Dr. Fincher treats, he says those caused by acne are the most difficult to repair. “Severe acne scars can be very challenging, because they have so many different kinds of scars. There can be broad scars, raised scars, ice pick scars—which are like tiny little pin pricks—so you wind up having to do a whole combination of different treatments.”

Scar Solutions

“We have various techniques to fill in scars, to reduce or flatten them, or we can do an injection to raise a scar,” says Dr. Fincher. “For texture with acne scars, where you want to plump up the scar, different types of lasers are helpful.”

Lasers work by penetrating the skin with energy, which breaks down scar tissue below the surface. Lasers also stimulate your body to make new collagen in a more controlled manner; when old, damaged skin is removed, your body makes new collagen, which is fresher, tighter and plumper.

“My goal will be to bring up the depressed scars, and lower the raised scars, evening out the surface of the skin,” says Dr. Fincher. He might then follow with a filler like Restylane or Radiesse, both of which are natural and dissolve over time.

But treating scars isn’t just about texture. It’s also often about discoloration, and addressing both texture and color may require a combination of treatments. “We also have pulse-dye lasers, which are used for taking redness out,” says Dr. Fincher. “So for example, with post cardiac surgery for sternotomy [chest] scars, we’ll use the pulse-dye laser to take the color out and use an injection of cortisone to flatten it.”

While existing laser technologies can remove color from skin, it’s difficult to restore color to what is known as a ‘hypopigmented’ scar, where the skin has lost flesh tone or is white. A CO 2 fractionalized laser can sometimes help restore the color, or your doctor may pre-treat the scars with a chemical peel treatment, then use the laser afterwards.

Finding Dr. Right

While your scar solution may be in sight, a critical element is finding the right doctor. among other things, an aesthetic sense is also important, so seeing the previous work done by your doctor is important.

“An artistic eye is important in cosmetic surgery, because we’re dealing with not only form and function, but just like sculpture, with a three-dimensional surface,” says Dr. Hayes Gladstone, associate Professor and director of Dermatologic Surgery at Stanford. “So you have to understand curves and lines. and just as an artist needs to understand shadows, so does a cosmetic surgeon, because that allows you places to hide the scars.”

Realistic Expectations

Unfortunately, there are no magic bullets for scars, and combination treatments as well as multiple treatments are typically needed to get good results. one laser treatment, which lasts about an hour, can cost $500, and if multiple treatments are necessary, as in the case of severe acne, it could cost as much as $5,000. and if fillers, such as collagen, Restylane, or Radiesse, are used to correct depressed scars, you could be looking at an additional $450 (collagen) to $1,000 (Radiesse). these last approximately 3 to 12 months, respectively, and thus would require periodic retreatment.

The good news is that you can expect to return to your daily schedule fairly quickly. While you may experience some swelling and redness for a few days after laser treatment, facial-filler side effects are mild, including possible bruising, swelling, or an “overfilled” appearance, which subsides in a few hours, or days.

Bottom line? Whether big, small, red or white, solutions for scars abound. With the right doctor and the right treatment, you can face the world scar free.