I was once visited by a lovely lady who suffered severe facial bone fractures around one of her eyes that required surgery to stabilize the bone. Her surgical scars contracted over the following few months, pulling her eyelids together until she could only partially open her eye. The scars limited her peripheral vision, affected her balance, her work as a clinician, and the first impression she made on others.

Scar contractures occur in the final phase of wound healing and tend to form where there is mechanical tension. Because the scar tissue is tighter than normal skin, it can limit movement or cause discomfort.

When the scar contractures developed, the plastic and ophthalmic surgeons she sought help from told her that there was nothing they could do because further surgery would cause even more scarring. She came to see me because she knew I’ve had success using ablative lasers to improve scars and she agreed to the treatment I recommended.

To initiate the treatment, I protected her eye by inserting what looks like a metal contact lens. I then used an ablative erbium laser to cut the fibrous scar bands that were pulling her outer lids together. A fractionated ablative laser treatment followed over the rest of the scars to replace a percentage of the gristly, contracted scar tissue with normal, stretchable skin. Fractionated ablative lasers can restore normal movement, decrease pain, and improve the appearance of thickened scars.

I injected the treated areas of the scar after the treatments with a medication to help prevent the scar from re-contracting. We repeated the fractionated part of the laser treatment a month later.

When I saw this lady again a few months later, her scars were almost imperceptible, her vision and balance were restored and she’d regained her confidence. We were both thrilled by the results and she asked me to publish her case so others would know about scar treatment options.

Improving scars really can change someone’s life and it goes to show that happy endings are possible even if the story has a tragic beginning.