Elevated glabella scar/cyst remaining from surgery 10 years ago, how to flatten without injections or large ellipse excision

Question

See photo captions. I've had many laser treatments for full face acne scarring but this bump hasn't responded to any. Fillers may help the depressed areas but is there a tiny incision technique or co2 punch that may flatten the elevated part? Raised scars are supposed to be easier to deal with than depressed but 2 local surgeons didn't have ideas other than a full ellipse excision. Who do I ask?

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

Nelson Lee Novick, MD · Answer

First, it is important to have the "bumps" properly diagnosed. If it is determined that a glabellar muscular component is contributing to the persistence of these bumps, then a neuromodulator, such as Botox, Dysport or Xeomin may be used to suppress any muscular component that may be playing a part in their development or maintenance. If these bumps do not respond, the Botox will still help to suppress the muscular activity in this region that will impair and impede healing from any treatment undertaken in the region. Following this appropriate doses of an antiinflammatory, such as triamcinolone, may be tried to reduce any fibrosis that may be playing a role. Sometimes I have found that an appropriate amount of hyaluronidase injected along with the injection--to promote better dispersion-of a properly titrated dose of an antiinflammatory is necessary to flatten the bumps and that several treatment sessions are required to do so. Most recently a similar bump above the eyebrow region in one of my patients required four sessions to achieve satisfactory flattening. Make sure you consult with a board certified aesthetic physician. Best of luck.

Jason Emer, MD · Answer

This scar can be improved with laser spot treatment, fillers, microneedling/prp and subcision to help texture and blending. I recommend getting a formal evaluation with a scarring expert. Best, Dr. Emer

Kristine Brecht, MD (license suspended) · Answer

Thick scarring like this can be improved with microneedling and prp.Optimally the this scar would be cut out and healed as a thin line, and then microneedling.Choose an expert. Best. Dr Brecht

Elevated glabella scar/cyst remaining from surgery 10 years ago, how to flatten without injections or large ellipse excision

Answers (4)

Answer: Thick scarring

Answer: Thick scarring

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Everything you need to know about Scar Removal

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Elevated glabella scar/cyst remaining from surgery 10 years ago, how to flatten without injections or large ellipse excision

Answers (4)

Answer: Thick scarring

Answer: Thick scarring

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Recommended reading

Everything you need to know about Scar Removal

Our mission is to create a world where every investment in modern beauty is Worth It.