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Scar Revision: Deep Indented Forehead Trauma Scar - Fraxel or W/Z Plasty or Combo?

My fiancee's trauma scar on her forehead is indented and looks like she got hit with a hatchet. What scar revision methods would have the best results for this? Fraxel re:store, W-plasty, Z-plasty, or a combo? Or other? (the photo is not of my fiancee - she is too embarrassed to post a pic, but this pic gives you an idea of what hers looks like, although hers is a vertical scar). Thank you in advance for you replies.

Doctor Answers (4)

Z-plasty probably the best choice


Z-plasty for scar revision will accomplish 2 things:


  • Minimize tension on the closure to prevent a recurrent depression
  • Camouflage the scar by breaking up how the light is reflected from the scar making it less noticable 
Augusta Plastic Surgeon
4.5 out of 5 stars 8 reviews

Scar revision is the only choice for a deep depressed scar. Fraxel doesn't work.


Fraxel therapy is very disappointing for scars.  The scar in the photo would require a revision, the specifics of which depend upon the orientation and depth of the scar as well as the expectations of the patient.

Web reference:

Atlanta Plastic Surgeon
4.5 out of 5 stars 6 reviews

Forehead Scar Revision


If your fiancee's scar is representative of the picture then I would recommend a surgical scar revision.  It could be a z-plasty, w-plasty, etc.  This depends on the nature of the scar and the surgeon's experience with these techniques.

Dr. ES

Atlanta Plastic Surgeon
5.0 out of 5 stars 6 reviews

Scar Revision: Deep Indented Forehead Trauma Scar - Fraxel or W/Z Plasty or Combo?


First do the scar revision than after healing for 6 weeks if needed treat with laser. Discuss with your PS. From MIAMI DR. Darryl J. Blinski

Miami Plastic Surgeon
4.5 out of 5 stars 55 reviews

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.

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