Forehead Scar and resulting wrinkles? (photo)

Question

When I was very young I was in an accident and received stitches across my forehead and now, at the age of 23, there is still a very deep scar, and several deep horizontal wrinkles have also formed. I have not tried any treatment. I have looked at botox, fraxel, and excision as potential options but am not sure what would be best. How should this be approached?

Michael I. Echavez, MD · Answer

In my opinion, the best option to improve your forehead scar would be to surgically revise it.  The scar appears fairly deep and I do not believe that Botox or Fraxel would significantly improve it.

Raffy Karamanoukian, MD, FACS · Answer

Surgical revision and Botox are both good options to treat your scar on your forehead. Our office specializes in scar revision in Los Angeles.Raffy Karamanoukian MD FACS

Nelson Lee Novick, MD · Answer

Subcision can be effective for permanently elevating depressed scars of various types, including traumatic scars,  those resulting from surgery, and infection-related. Subcision is a procedure in which a sterilized needle is inserted, following the administration of local anesthesia, directly beneath a depressed scar (regardless of whether from acne, infection, trauma, or surgery) and used to break up the thick bands of fibrous scar tissue that bind down the surface and create the depression.Breaking up the abnormal bands of thickened, scar collagen accomplishes two things. First, it allows the surface of the scar to float to the surface. In addition, the tissue fluid that immediately fills the space following treatment contains growth factors and other wound healing substances that promote neocollagenesis, native collagen production, that allows for improvement and elevation of the scars. Between two to four treatments, spaced at six week intervals, are generally required to promote sufficient new collagen to achieve a satisfactory improvement. Since, the collagen produced is one's own, the results of subcision are typically permanent.Fractional microneedle therapy aka medical microneedling works by creating numerous areas of controlled microwounding that set off in turn a cascade of events that result in new, native collagen synthesis, which translates into healthier, thicker skin that improves the appearance of the underlying scars. It is particularly useful for improving the surface tone and texture of skin to enhance blending with the surrounding normal skin. To date, I have unfortunately been less than impressed with the results of fractional lasers despite the media hype they have received.The injection of a stimulatory filler(s), such as Radiesse or Radiesse combined with Perlane L (in my Upper East Side Manhattan practice.) or Radiesse combined with Restylane SQ (my Israel office) can not only lead to immediate lifting of the scar and smoothing of its surface, but can further enhance new native collagen synthesis (neocollagenesis) about two months afterward.I believe that the additional use of a neuromodulator, such as Botox,  Dysport, or Xeomin in this particular case would serve two purposes. One obvious benefit would be to alleviate some of the pronounced "worry line" wrinkling that is obvious with expression in the photo. However, at least as importantly, by suppressing some of the movement, the scar would be allowed to heal from the above treatments with less stretching and distortion, which ultimately translates long-term into a better overall cosmetic result.Of course, consultation with a board certified aesthetic physician who is skilled and experienced in all these modalities is an absolute must.

Darryl J. Blinski, MD · Answer

I would recommend only in person opinions vs over the internet opinions.. But to give you an idea of my recommendations- Surgical Excision with drops of BOTOX in edges. Than after 1 month micro needling with DERMAPEN using PRP+Vit E oil in 4 sessions. Cost $2,500..

Elizabeth F. Rostan, MD - Account Suspended · Answer

I would recommend a combination of laser treatment with a Fraxel laser such as Fraxel re:store and botox to relax the lines of muscle movement that are now creasing the scar further. Additionally a little bit of filler can be put under the scar to improve the depth of the scar - Belotero is a great option for this as it can be placed very close to the skin surface.

Forehead Scar and resulting wrinkles? (photo)

Answers (5)

Answer: Forehead Scar and resulting wrinkles? (photo)

Answer: Forehead Scar and resulting wrinkles? (photo)

Answer: Forehead scar options

Answer: Forehead scar options

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Everything you need to know about Scar Removal

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Forehead Scar and resulting wrinkles? (photo)

Answers (5)

Answer: Forehead Scar and resulting wrinkles? (photo)

Answer: Forehead Scar and resulting wrinkles? (photo)

Answer: Forehead scar options

Answer: Forehead scar options

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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.