Correcting an indented scar on upper lip - can this be fixed without leaving a worse scar? (Photo)

Thank you for sharing the details about your lip and scar history. I completely understand wanting to improve the indentation without creating a new problem, especially on such a delicate area like the upper lip.

Why the indentation persists:

Even minor cuts can heal with subtle tissue loss underneath the skin, leading to a small depression.

Since your scar feels smooth and not raised or rough, this is likely just a minor volume deficit rather than significant scar tissue.

Treatment options without filler:

Subtle surgical revision (scar revision or Z-plasty): A skilled surgeon can sometimes release and reposition tissue to smooth the indentation.

Microneedling or gentle resurfacing: In select cases, very conservative microneedling can stimulate collagen slightly and improve the contour, though changes are usually modest.

Laser resurfacing: Carefully performed non-ablative laser treatments can improve skin tone and slight depressions but may have limited effect on deeper indentation.

Risks to consider:

Since your skin is fair and prone to long-lasting discoloration, any procedure carries a small risk of temporary pigmentation changes.

With careful technique and conservative treatment, the risk of creating a worse scar is low. The key is gentle, precise intervention rather than aggressive correction.

Your permanent lip color should be noted before any laser or resurfacing treatment, as some lasers may affect tattoo pigment.

Summary:
Your upper lip indentation can potentially be improved without filler, but results are usually subtle and depend on technique. Conservative surgical revision, careful resurfacing, or microneedling may help, with minimal risk of worsening the scar when done cautiously. Patience and precision are essential to avoid discoloration or new scarring.

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture. Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.


Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best,
Dr. Karamanoukian
Realself100 Surgeon