Does fat grafting work with these type of indented scar? (Photo)

Question

I have had these indented scars since I was very young when I was about five, obtained from falling on a sharp table edge and receiving stitches. The scar tone itself blends into my surrounding skin, the only problem is the scar creates a shadow. I would like to know if fat grafting would work and if so could I combine it with subcision to fill the spot and make it look smooth as if it was never there?

Nelson Lee Novick, MD · Answer

I have been performing subcision since 1995 with very gratifying results in elevating and smoothing all kinds of indented scars, from all causes, and in all skin types. It is a simple and relatively inexpensive treatment when performed by an experienced board certified cosmetic dermatologist scar treatment specialist. The additional use of an appropriate HA filler may also be considered, as these can help to further promote new collagen synthesis. 
I stopped performing fat injections many years ago, since this is an expernsive, two-step procedure that requires fat withdrawal from a donor area via large cannulas and fat injections via large cannulas into the recipient site. Secondly, although there is the promise that the results are permanent, this is seldom the case, as much of the fat from the donor site separated from its original blood supply does survive. Additionally, owing to the use of the larger cannulas, there is often significant post-treatment downtime.  Finally, unlike HA fillers which can be rather easily dissolved should the need arise, this is not the case with fat injections. Make sure to consult with an experienced, board certified cosmetic dermatologist with expertise in performing subcision, since so many venues these days are so busy hawking expensive "bells and whistles" light and energy-based treatments these days that few places possess the requisite experience. Hope this helps and best of luck.

Raffy Karamanoukian, MD, FACS · Answer

Our treatments use combination therapy to improve the epidermis and dermis. We see atrophic and hypertrophic scars, as well as scars that have hypo and hyperpigmentation. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to discuss the best treatment options for your type of skin. .

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Anna Chacon, MD, FAAD · Answer

Hello,

Fat grafting can be a viable option for treating indented scars, as it involves transferring fat from another part of your body to the scarred area to add volume and smooth out the indentation. This procedure can help reduce the shadow effect created by the indentation.

Combining fat grafting with subcision, a technique where a needle is used to break up fibrous tissue beneath the scar, can enhance the overall outcome. Subcision releases the scar tissue tethering the skin down, allowing the fat graft to better fill the area and create a smoother surface.

However, the success of these treatments can vary based on the specific characteristics of your scar, such as its depth, size, and location. It's essential to have a thorough consultation with a board-certified dermatologist or plastic surgeon who has experience in scar treatments to assess your scar and discuss the best treatment options for you.

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