Scar Revision Solutions in Los Angeles

Kare Plastic Surgery & Skin Health Center  ·  Santa Monica & Los Angeles

Scar Revision Los Angeles

804 7th Street, Santa Monica, CA 90403  ·  Near Montana Avenue  ·  (310) 998-5533

Surgical scar revision, keloid trimodal protocol, Z-plasty, CO2 laser, and Vbeam by national keloid authority and UCLA-trained dual board-certified plastic surgeon Dr. Raffy Karamanoukian at Kare Plastic Surgery in Santa Monica

Call (310) 998-5533 Request a Consultation
📍 804 7th Street, Santa Monica — Near Montana Avenue
📞 (310) 998-5533
🌟 National Keloid Authority — 20 Years Experience
💪 UCLA-Trained Dual Board-Certified Plastic Surgeon
UCLASchool of Medicine
NationalKeloid Authority
TrimodalKeloid Protocol
Z-PlastyW-Plasty & Excision
CO2Laser & Vbeam
 

No Scar Is Permanent. The Right Approach Makes the Difference.

Dr. Raffy Karamanoukian MD FACS — UCLA-trained national keloid authority and dual board-certified plastic surgeon specializing in scar revision at Kare Plastic Surgery Santa Monica Los Angeles
Dr. Raffy Karamanoukian, MD, FACS Dual Board-Certified Plastic Surgeon  ·  National Keloid Authority Graduate, UCLA School of Medicine  ·  Scar Revision · Keloid · Hypertrophic · Traumatic · Laser · Vbeam · All Skin Types  ·  Kare Plastic Surgery, Santa Monica

A scar is the body's permanent record of an injury, surgery, or skin condition. For most people, a scar in a visible location carries an emotional weight far beyond its physical dimensions — it changes how they look in photographs, how they feel in social situations, and for some patients, how they understand their own reflection. The goal of scar revision is not to erase that record completely, because no technique in medicine can do that. The goal is to make the scar so inconspicuous that it no longer matters in the daily life of the person who carries it.

At Kare Plastic Surgery and Skin Health Center at 804 7th Street in Santa Monica near Montana Avenue, UCLA School of Medicine graduate and dual board-certified plastic surgeon Dr. Raffy Karamanoukian, MD, FACS is a nationally recognized authority on scar revision and keloid treatment with 20 years of dedicated experience treating scars across every type, location, and skin tone. He is the plastic surgeon that celebrity families trust with emergency facial repairs, the specialist that complex keloid cases are referred to from across Los Angeles, and the physician whose before and after photography across the cases documented below represents the most comprehensive scar revision outcomes library in the Santa Monica and Beverly Hills market.

20 YrsScar revision and keloid expertise
NationalKeloid authority — complex cases accepted
AllSkin types I through VI treated
CelebrityCases treated at Kare Scar Center

Scar Revision Services at Kare Plastic Surgery Santa Monica

  • Surgical scar excision with no-tension layered closure
  • Z-plasty and W-plasty for scars crossing natural skin creases
  • Keloid trimodal protocol — excision, intraoperative cortisone, injection series, Vbeam
  • Intralesional triamcinolone plus 5-FU injection series for keloids and hypertrophic scars
  • Vbeam 595nm pulsed dye laser — red, raised, and vascular scar suppression
  • Fractional CO2 laser resurfacing — atrophic, acne, and surface-irregular scars
  • Ear keloid surgery — complete excision with anatomical preservation
  • Pubic and lower abdominal keloid protocol
  • Traumatic and laceration scar revision
  • Post-surgical scar revision — tummy tuck, C-section, facelift scars
  • Forehead and facial scar management in all skin types
Kare Plastic Surgery  ·  Santa Monica  ·  Near Montana Avenue
Ready to address a scar that has bothered you? Schedule a consultation with Dr. Karamanoukian today.
Patient Results — Dr. Raffy Karamanoukian  ·  Kare Plastic Surgery & Scar Treatment Center, Los Angeles

Scar Revision Results — Across Scar Types and Skin Tones

Actual patients of Dr. Karamanoukian  ·  Individual results may vary  ·  All skin types treated

Before and after results across six scar types — keloid, forehead railroad scar, trunk inflammatory scarring, massive ear keloid, philtrum traumatic laceration, and earlobe repair. All patients of Dr. Raffy Karamanoukian at Kare Plastic Surgery and Scar Treatment Center, Santa Monica. Individual results may vary.

 

Every Scar Is Different. Every Treatment Plan at Kare Is Individual.

The single most important principle of scar revision is that the treatment must match the biology of the specific scar in the specific patient. A keloid scar in a patient with Fitzpatrick type VI skin on the chest requires a completely different approach than an atrophic acne scar in a fair-skinned patient on the cheek, which is different again from a widened surgical scar on the abdomen. Applying the same protocol to different scar types produces poor outcomes. Dr. Karamanoukian's consultation process begins with a precise clinical classification of the scar and an honest assessment of what each available treatment modality can and cannot achieve for that individual patient.

Keloid Scars

The most clinically challenging scar type. Keloids grow beyond the original wound boundaries because of a genetically driven pathological collagen response. They are more common in patients with darker skin types and at high-tension anatomical sites. Ear keloids, chest keloids, jawline keloids, and pubic keloids are the most common presentations at Kare Plastic Surgery. Surgery alone carries up to 90% recurrence. Dr. Karamanoukian's trimodal protocol combines excision, intraoperative cortisone, injection series, and Vbeam to produce durable outcomes. See the ear keloid and pubic keloid results above.

Hypertrophic Scars

Raised, red, firm scars that remain within the original wound boundaries — unlike keloids which extend beyond them. Hypertrophic scars are driven by wound tension, infection, or individual healing variation. They tend to improve over 12 to 24 months but plateau without treatment. Intralesional triamcinolone injection series, Vbeam laser, and silicone compression produce reliable improvement. Surgical re-excision with no-tension layered closure is indicated for resistant or wide hypertrophic scars.

Traumatic Scars

Scars resulting from lacerations, dog bites, burns, abrasions, and accidents. The appearance of a traumatic scar is determined largely by the quality of the original wound repair. Scars from ER closures or poorly managed lacerations often present with railroad track marks, widening, step-off irregularity, or pigmentation mismatch. Dr. Karamanoukian performs re-excision with no-tension layered closure, Z-plasty when scar direction crosses natural skin lines, and Vbeam and CO2 laser for surface and vascular components. See the philtrum traumatic scar result above.

Post-Surgical Scars

Scars from cosmetic and reconstructive surgery — including tummy tucks, breast procedures, facelifts, and C-sections — can be revised when they are placed too high, too wide, irregular, or thickened. Dr. Karamanoukian performs scar repositioning, re-excision with deep dermal closure, and laser management for post-surgical scars. Early Vbeam intervention at 4 to 6 weeks after the original surgery prevents scar thickening before it fully establishes.

Atrophic Scars

Scars that heal below the surrounding skin surface — including acne pitting, chickenpox marks, and ice pick scars. Treated with fractional CO2 laser resurfacing, subcision to release tethered scar tissue, dermal filler for volume restoration, and TCA Cross for focal deep ice pick scars. See the chest and abdominal scar improvement above showing the dramatic surface-level improvement achievable with scar resurfacing.

Contracture Scars

Scars that tighten across joints, skin creases, or functional anatomical areas — most commonly from burns, deep lacerations, or prior surgery. Contracture scars restrict movement and require release with Z-plasty, W-plasty, or skin grafting to redirect scar forces across a longer path and restore full range of motion. Dr. Karamanoukian advises on the appropriate technique at consultation based on the specific contracture location and severity.

Surgical Scar Revision Techniques at Kare Plastic Surgery

Surgical scar revision removes the existing scar and replaces it with a more favorable scar planned and executed with precision. The specific technique depends on the scar's orientation, width, depth, location, and the relationship between the scar direction and the natural skin tension lines of that anatomical region.

Simple excision with layered closure is appropriate for widened, thickened, or irregularly surfaced scars that run parallel to or within natural skin lines. The scar is excised with tapered ends and the wound closed in multiple layers — deep fascial, deep subcutaneous, deep dermal absorbable sutures, and finally fine monofilament skin sutures. The deep dermal layer provides the permanent tension-bearing strength of the closure so the skin surface heals under zero tension.

Z-plasty is used when a scar crosses the natural skin creases at an angle that produces mechanical tension, distortion, or a pull on adjacent structures. The Z-plasty technique transposes two triangular tissue flaps to reorient the scar along a more favorable direction, lengthening the scar line and breaking the linear tension that causes the original scar to pull. It is particularly valuable for contracture scars and for scars that cross the nasolabial fold, the lip commissure, or other anatomical landmarks where a linear scar creates noticeable distortion. W-plasty creates a zigzag scar pattern that breaks up the linear visual continuity of the original scar line, making it harder for the eye to track as a single line.

"The consultation is where I decide what approach will produce the best outcome for this patient's specific scar. I have seen patients who were told their scar could not be improved significantly, and I found a technique that dramatically changed their result. I have also seen patients with unrealistic expectations who needed honest counseling about what was achievable. The conversation at consultation is as important as the surgery."

— Dr. Raffy Karamanoukian, MD, FACS  ·  Kare Plastic Surgery, Santa Monica  ·  National Scar Authority

Keloid Treatment — National Authority  ·  Kare Plastic Surgery, Santa Monica

The Kare Trimodal Keloid Protocol — Surgery Alone Is Not Enough

The most effective keloid management in Los Angeles  ·  Surgery + injection series + Vbeam laser

Ear keloid massive auricular before and after surgery at Kare Plastic Surgery Los Angeles by Dr. Karamanoukian — complete ear keloid removal with ear anatomy fully restored
Ear Keloid  ·  Before and After Surgical Excision Massive auricular keloid consuming entire ear architecture · Full anatomical restoration post-surgery
Pubic keloid before and after one year treatment at Kare Plastic Surgery Los Angeles Scar Treatment Center — raised hyperpigmented keloid dramatically improved with trimodal protocol
Pubic Keloid  ·  Before and After  ·  1 Year Raised lobulated keloid · Fitzpatrick V-VI · Trimodal protocol · 1-year result

Left: Massive auricular keloid in which the entire ear structure was consumed by the keloid mass — after surgical excision, the natural helical rim, antihelix, and conchal bowl are fully and precisely restored. Right: Lower abdominal pubic keloid in a patient with darker skin — before showing raised lobulated hyperpigmented keloid, after at one year showing dramatic flattening and pigmentation normalization with the trimodal protocol. Dr. Raffy Karamanoukian, MD, FACS  ·  Kare Plastic Surgery, Santa Monica

The Kare Trimodal Keloid Protocol: At surgery — complete keloid excision plus intraoperative triamcinolone injection into wound margins before skin closure. Post-op weeks 1 to 8 — silicone compression tape worn continuously. Post-op weeks 4 to 6 — Vbeam 595nm pulsed dye laser targets the new vascular network driving recurrent collagen overproduction. Post-op months 1 to 6 — sequential triamcinolone plus 5-fluorouracil injection series every 4 to 6 weeks. Surgery alone for keloids carries recurrence rates up to 90%. This protocol reduces that risk dramatically and is responsible for the durable results in the before and after photography above.

 

Fractional CO2 Laser and Vbeam — Non-Surgical Scar Treatment at Kare Plastic Surgery

Not every scar requires surgical revision. For patients with surface-level texture irregularities, atrophic scarring, post-inflammatory pigmentation changes, or vascular red scars, non-surgical approaches at Kare Plastic Surgery can produce meaningful improvement without incisions, sutures, or surgical downtime. Dr. Karamanoukian selects the appropriate laser modality based on the specific characteristics of each scar at consultation.

Fractional CO2 Laser Resurfacing for Scar Treatment

Fractional CO2 laser delivers thousands of microscopic columns of ablative laser energy into the scar surface, creating controlled zones of thermal coagulation that stimulate the production of new collagen and elastin while the surrounding untreated skin accelerates healing. For atrophic and surface-irregular scars, fractional CO2 produces measurable improvement in scar surface texture, depth, and pigmentation over a series of 2 to 4 treatments spaced 6 to 8 weeks apart. The improvement develops progressively over 3 to 6 months as the neocollagenesis response matures and the scar surface continues to normalize. Fractional CO2 is also combined with surgical scar excision for patients who have both structural and surface-level components to their scar that benefit from addressing simultaneously.

Vbeam 595nm Pulsed Dye Laser for Red and Raised Scars

Vbeam laser at 595nm targets the abnormal vascularity within red, raised, and hypertrophic scars — the network of small blood vessels that supplies the inflammatory cytokines sustaining pathological collagen overproduction. By selectively destroying these vessels without damaging the surrounding skin, Vbeam interrupts the scar's growth signal and allows it to flatten, fade, and soften. It is one of the most important tools in Dr. Karamanoukian's scar management protocol: used at 4 to 6 weeks after any surgical closure or laceration repair to prevent hypertrophic scar formation before it establishes, and used throughout the keloid injection series to enhance the compression and flattening achieved by the triamcinolone and 5-FU injections. The forehead scar and traumatic scar improvements in the gallery above both demonstrate Vbeam's effectiveness as part of a combined treatment approach.

Celebrity Scar Cases at Kare Plastic Surgery

Dr. Karamanoukian's expertise in emergency laceration repair and scar management has earned the trust of celebrity families in Los Angeles. In May 2023, Alfonso Ribeiro — best known as Carlton from The Fresh Prince of Bel-Air — brought his 4-year-old daughter Ava to Dr. Karamanoukian at Kare Plastic Surgery following a serious emergency facial injury. The case was covered internationally by the Daily Mail and The U.S. Sun. When a celebrity family faces an emergency involving a child's face, they make the same choice every patient in Los Angeles can make: they call Dr. Karamanoukian.

The U.S. Sun article about Alfonso Ribeiro daughter Ava emergency surgery treated by Dr. Karamanoukian at Kare Plastic Surgery Los Angeles Santa Monica
Daily Mail article Alfonso Ribeiro daughter Ava emergency injury treated at Kare Plastic Surgery Los Angeles by Dr. Raffy Karamanoukian

Coverage by The U.S. Sun and Daily Mail, May 2023, of Alfonso Ribeiro's daughter Ava following emergency treatment by Dr. Raffy Karamanoukian at Kare Plastic Surgery, Santa Monica. Dr. Karamanoukian's inset in The U.S. Sun confirms his role as treating physician.

Frequently Asked Questions About Scar Revision in Los Angeles

Where can I get scar revision in Los Angeles?

Kare Plastic Surgery at 804 7th Street in Santa Monica near Montana Avenue offers expert scar revision by UCLA-trained national keloid authority Dr. Raffy Karamanoukian. All scar types treated — keloids, hypertrophic scars, traumatic scars, post-surgical scars, and atrophic scars — with surgical, laser, and injection protocols. All skin types including Fitzpatrick V and VI. Call (310) 998-5533. We serve patients from Santa Monica, Beverly Hills, Brentwood, Malibu, and all of Los Angeles.

How long does scar revision take to show results?

The timeline depends on the scar type and the treatment modality. After surgical scar excision, the new incision line is red and slightly raised for 6 to 8 weeks before beginning to fade, with the final result typically visible at 12 months as the scar fully matures. Vbeam laser treatments produce measurable improvement in redness and texture within 2 to 4 sessions spaced 4 to 6 weeks apart. Keloid injection series produce progressive flattening over 4 to 8 injection visits. Fractional CO2 laser continues to improve the scar surface over 3 to 6 months after the last treatment session. Dr. Karamanoukian provides specific timeline expectations for your individual scar at consultation.

Can keloid scars come back after surgery?

Surgery alone carries recurrence rates for keloids of up to 90% because the surgical wound activates the same pathological collagen response that created the original keloid. The Kare trimodal protocol — excision combined with intraoperative cortisone, followed by a structured 6-month injection series and Vbeam laser — reduces keloid recurrence dramatically compared to surgery alone. Dr. Karamanoukian's before and after results for ear keloids and pubic keloids on this page demonstrate the durable outcomes achievable with the complete protocol. Call (310) 998-5533 for a keloid consultation.

Is scar revision covered by insurance in Los Angeles?

Cosmetic scar revision is typically not covered by insurance. However, scar revision that addresses a functional impairment — such as a contracture scar that restricts joint movement, a scar causing ectropion of the eyelid, or a scar that resulted from a covered surgical procedure or accident — may qualify for insurance reimbursement depending on your specific plan. Dr. Karamanoukian's team reviews your scar history at consultation and advises on insurance documentation when a medical necessity argument applies to your case. Call (310) 998-5533.

Kare Plastic Surgery & Skin Health Center  ·  Santa Monica  ·  Near Montana Avenue

Schedule a Scar Revision Consultation

Dr. Raffy Karamanoukian, UCLA School of Medicine graduate, dual board-certified plastic surgeon, and national scar authority offers comprehensive scar revision consultations at Kare Plastic Surgery in Santa Monica — all scar types, all skin tones, surgical and non-surgical approaches, for patients across Los Angeles and Beverly Hills.

(310) 998-5533
 
Online Consultation Request 804 7th Street  ·  Santa Monica, CA 90403

Kare Plastic Surgery & Skin Health Center  ·  804 7th Street, Santa Monica, CA 90403  ·  Near Montana Avenue  ·  (310) 998-5533

Dr. Raffy Karamanoukian, MD, FACS — UCLA School of Medicine  ·  Scar Revision · Keloid · Hypertrophic · Z-Plasty · CO2 Laser · Vbeam · All Skin Types  ·  Santa Monica · Beverly Hills · Los Angeles