I have 2 lesions on my forehead from chickenpox that I wish to revise. I went to a local plastic surgeon who wanted to excise both lesions, suture them shut, and apply botox. She said the botox will reduce the tension on the revised scars, which will reduce the overall width of the scar. I've heard testimonials from people who've had similar procedures without the botox, and they stated that the scars eventually spread out to look similar to the scars before. Will botox make a difference?
What is an Effective Way to Revise Lesions Left from Chicken-pox on the Forehead?
Doctor Answers 5
I think your intuition is very good here.
The choice to revise a scar can be very difficult. The chickenpox scar is probably very mature and quiet. I suspect that direct excision of this lesion with or without BOTOX will result in a scar and forehead deformity that is worse than the current pox mark. To be worth revisional surgery, there must be a high probability of a very satisfactory improvement and a very low probability of a result that is less satisfactory than the current scar. I would encourage you to repost your question with photographs. They will help us be a little more concrete in answering.
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Chicken Pox scars cosmetic treatment
There are many different methods of treating acne scars. There has been a theory promoted that Botox relaxation of the forehead frontalis muscle may decrease pulling on scars and leave a more satisfactory result, but many scars on the forehead heal beautifully well without Botox so this is optional. The way in which the scar is removed is important. Some are wide and circular removals of round scars that are sewn together can easily create a stretch-back phenomenon and the scar won't look good. Often the removal needs to be longer than wide making the scar longer but better as it may spread less. Punch grafts can be done if the scar is not too wide in diameter. The scar is removed and a piece of skin from behind the ear is then placed in the new wound. Once healed the graft can be resurfaced with dermabrasion or laser.
The information provided in Dr. Shelton's answer is for educational purposes only and is not intended to constitute medical advice. The information provided should not be relied upon as a substitute for consultations with a qualified health professional who may be familiar with your individual medical needs. If you are experiencing a medical emergency proceed to your nearest emergency room.
I like excision of chicken pox scars and then Fraxel Restore Laser blending of the srugical scar if necessary.
Chicken pox scars have a deep sclerotic base that does not respond well to fillers. I recommed excision of chicken pox scars and then blending with the Fraxel Restore or Palomar 1540nm laser if necessay. In my hands, this gives the very best cosmetic result.
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Treatment options for chicken pox scars
I agree that excising a chicken pox scar is not likely to give an acceptable improvement. I have had a good deal of success injecting both chicken pox and acne scars with Restylane. Improvement can be anywhere from mild to dramatic and is usually quite long lasting. A smaller touch-up sized syringe can be used, making it a relatively inexpensive option.
Any scar revision can be difficult to achieve a better outcome. If you are older and have deeper forehead furrows, you may get good camouflage of the scars, but in younger smoother skin, you may just be trading one noticeable scar for another. Find a good facial plastic surgeon experienced in scar revision with before and after photos to prove it.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.