How can I remove this scar/dent on my forehead? (Photo)

Question

When I was 5 I hit my head on a sharp edge of a cabinet. I had some stitches but this dent is still on my forehead and it’s never going to go away. What can I do to get rid of it... it’s right in the middle of my forehead and it’s the first thing people look at. I just don’t like it.

Raffy Karamanoukian, MD, FACS · Answer

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. 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 decide whether early subcision should be started.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Toby Mayer, MD · Answer

Deep scar excision and Plastic Closure. This is what I recommend based on 43 years experience. Fillers will want to create a “donut “ around this.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. The best advice you can receive is from an in-person consultation. Based on your photograph, you may benefit from a surgical scar revision of your forehead scar. This decision should be based on a detailed discussion with equal input from both you and your surgeon. Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.

Best wishes and good luck.

Richard G. Reish, M.D. FACS

Harvard-trained plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D.  FACS

Harvard-trained plastic surgeon

Jason Emer, MD · Answer

This scar can be improved with a combination of surgery and/or lasers and microneedling/prp. I recommend getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer

Nelson Castillo, MD · Answer

Thank you for sharing your question and photograph.  Most likely the best initial treatment is a surgical scar revision to better align the underlying tissues combined with Botox placement into the muscle to prevent it from spreading the incision.  Once healed additional treatments such as micro needling would help improve the texture and tone.  Hope this helps.

Johnson C. Lee, MD · Answer

Thank you for your photo. For on older scar microneedling with or without PRP, fractionated laser, and radiofrequency make microscopic holes in the scar to stimulate your body to remodel and fill in the scar with new collagen. You may also need botox to prevent your forehead muscles from deepening the scar. Lastly, a scar revision or re-excision may swap out your old scar for a less noticeable one in a single procedure. Not everyone is a candidate for all the treatment options however as certain skin types can get worse from certain treatments. For the safest treatment plan, it is important to visit an expert for an in-person examination. Hope this helps!
Johnson C. Lee, MD 
Board-Certified Plastic Surgeon

Bruce E. Katz, MD · Answer

Thank you for your question. Based on your photo, you could benefit from laser skin resurfacing which stimulates your body to fill in under the scars with collagen.  You could also try injectable fillers to raise the scars and give your skin a smooth appearance. Hypertrophic scars can be treated with steroid injections that will diminish their appearance. It is always best to seek treatment from a board-certified dermatologist.

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