I had a shave biopsy done on my cheek for a mole that was flat on the surface. It has left me with a round hole the size of a pencil eraser. It has been 13 weeks and still looks bad to me. Will this ever level out or what can be done to fix it with out having an excision done to correct it. One end of the scar sticks up a little more which seems to be making the shadowing of the scar more noticeable.
Indentation from Shave Removal on Cheek, What Can I Do To Fix This?
Doctor Answers (8)
This may level out, but unlikely. You may need to have an incision to remove the defect. See a Board Certified Plastic Surgeon to evaluate the location for a suitable correction.
Indentation after biopsy
As has been stated, often such depressions will fill in as they heal. If they fail to do so within a reasonable period of time, subcision is sometimes helpful. Injection of fillers under the scar sometimes provides temporary relief while the healing process takes places. Occasionally the scar requires excision and repair. One way or the other it is usually possible to achieve an acceptable aesthetic appearance of a scar in this area.
Sometimes simple massage or "pinching" the skin overlying the indentation multiple times a day for many weeks can improve the situation. Sometimes subsicion or the injection of a dermal filler (or even saline) is helpful. If it doesn't go away after several months, best to returh to the doctor who treated the scar or consult a board-certified plastic surgeon or dermatologist.
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Indentation after shave removal
Thank you for the photo - it is very helpful in answering your question. It is common to have a slight indentation after a shave removal. Hopefully, it will fill in over time. Right now, your scar is going through a "contraction" phase. It will continue to remodel for up to 12 months. I know this sounds like a long time, but it should get slowly better and better. I recommend starting scar massage at 8 weeks after a skin surgery - so you could start doing this. If it is still indented after 4 months, then you could consider having a filler, such as Juvederm, or Restylane, placed under the scar. Another option after 4 months, would be to have a punch excision done on the scar and brought together with a suture. Hang in there - and if you're willing, be sure to go back to the doctor that did the shave so that you can work together to make it look cosmetically right.
Shallow scar on the cheek after surgery
Dear Steph, I suggest considering a procedure known as "subcision", combined with a spot Dermabrasion or chem-abrasion. Your dermatologist/plastic surgeon can help you decide , after considering your skin type [ fair skin vs olive complexion]. A filler may be an option, after this maneuver[s]
Indentation after biopsy
Dear Steph, Unfortunately I have seen this happen all too commonly. If the biopsy goes too deeply into the middle (dermis) layer, the patient will be left with an indention. During the first few weeks the skin has to grow back over the biopsy site. Some patients can be red in that area for the first month. However, now three months have passed, so it is getting more likely this indentation will be permanent. I would still advise that you wait for at least 6-12 months before any intervention. If the site is still indented, I have helped many patients with my FaSuLa scar revision surgery. Basically, a small tunnel is make just under the scar, and a graft is placed inside this tunnel to elevate the skin so it is flush again with its surroundings. You can read more about it on my website. In my opinion it would not be appropriate to do fat grafting for your situation, because the problem is not with the fat layer- it is more superficial.
Yoash R. Enzer, MD
Wound Care for Shave Removal
After looking at the picture you have posted, it appears that the shave removal may have taken place recently. If this is true, I would like to reassure you that this will likely improve with some good wound care and time. My recommendation at this time would be good wound care. I suggest taking one tablespoon of vinegar mixed with a pint (2 cups) of warm water and soak the area for 15min 2-3x/day. Then place some vaseline and a spot bandage. Keeping the wound moist is key for the best and quickest resolution. It may be pink for awhile, but that will resolve. Once it is completely healed, there still may be an indentation, but I would not make that judgement until at least a month or two from now. There will be a lot of remodeling taking place.
Good luck, and stick to the wound care. I am sure it will improve much more than what we can see in the picture, but the wound care is critical.
Scar Revision with Fat Grafting
Many times we are left with unsightly scars which are indented after removal of skin lesions, traumatic injuries, or after surgical procedures. Once the scar is allowed to "mature" for a period of 6-8 months it can be evaluated for revision. Many times indentations can be fixed by filling them with fat. Fat is harvested from the abdomen, packed in a syringe, and injected under the skin to fill the "void". Ne further incisions are usually necessary. It is an excellent procedure, and I have had much success. Good Luck, Dr. Corrado