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Can scar revision surgery be used to correct a hypertrophic scar on the forehead?

My 10 year old son fell last summer and gashed his forehead. The injury resulted in a raised hypertrophic scar. A plastic surgeon recommended massage with castoe oil. The scar is now almost flat. My Dr. said that he could do a scar revision since the scar is wide, but he wants to wait another 6 months. Does the scar need to be completely flat before surgery is done? Also my son is 10. Is it better to do the surgery now or wait until he is older (post puberty). Thank you

Doctor Answers (4)

Plato's Scar Serum and hypertrophic scars

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Hypertrophic scars on the forehead can be improved with a combination of fractional laser and surgical scar revision. Topical application of Plato's Scar Serum can also improve scars. 

Raffy Karamanoukian MD FACS


Los Angeles Plastic Surgeon
5.0 out of 5 stars 53 reviews

Scar therapy

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The gold standard for hypertrophic scar therapy is pressure and time - occasionally a year or more.  If this fails then scar revision surgery may be considered.  


Not infrequently potential patients avoid surgery because fear of an unsightly scar. To remedy this, I now utilize and formulate compounded topical creams to treat, relieve and minimize scars for each of my patients:

• new scars

• old scars

• surgical scars

• keloid scars

• stretch marks

• hypertrophic scars

• hyperpigmented (dark) scars

• various acne scars, and more...

These scar removal creams contain prescription strength medications each individually known to reduce and/or reverse the scarring process but never before compounded together into one high potency formulation. These medications are added to a base of anhydrous silicone (the most common ingredient in everyday topical scar therapy) and Pracaxi oil, found in the Amazon rainforest and known for its anti-inflammatory, antioxidant, antibacterial, and antifungal properties. Many health insurance plans actually cover the cost of the creams and they can be delivered directly to the patients door step. In other words, no need for multiple trips to the doctor for expensive and painful laser treatments, or wasted money on minimally effective over-the-counter scar therapy products. Instead, with just two applications a day my patients now perform scar therapy in the comfort of their own home.  Glad to help.

Ryan Stanton, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 24 reviews

Hypertrophic Scars Respond To Intralesional Injections And Fractional Microneedle Therapy

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Hypertrophic scars or "proud flesh" scars as they are often called because they typically protrude above the skin surface can be managed in a number of ways. If location is prominent, as in this case, treating with intralesional inflammatory injections to completely flatten the scar would be logical. It often speeds the fading of the reddish coloration that often characterizes active hypertrophic scars.

Once the scar is completely flat, i.e. flush with the surrounding normal skin, a decision has to be made as to how to proceed. If the resulting ivory-colored flat spot is acceptable, nothing more need be done. Certainly scar excision followed by dermabrasion (scarabrasion) is an option. Alternatively, a far less invasively, fractional medical microneedle therapy can be considered to improve the surface texture of the scar and possibly its color, as well. 

Should the decision be made to go ahead with further treatments, the timing is next important. In general I prefer to wait until the child himself/herself becomes bothered by the scar and is emotionally willing and able to comply with treatments. For more detail on fractional medical microneedle therapy, check out the archives of Realself.com

Nelson Lee Novick, MD
New York Dermatologic Surgeon
5.0 out of 5 stars 13 reviews

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Scar revision/reduction

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Sorry to hear about the accident and hope your son is well. There are a few options to help improve the appearance of this scar. Scar excision is an option but comes with the risk of the scar healing in a similar fashion. Lasers can also be used to help improve the appearance of the scar by blending them and this offers a noninvasive option. Creams can help very modestly but actually most of the improvement you saw was likely just due to time and the body improving the scar on its own. See a board certified physician with expertise in treating scars.

Omar Ibrahimi, MD
Stamford Dermatologic Surgeon
5.0 out of 5 stars 9 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.