What are realistic options for revision of a 22 y/o diagonal indented scar between eyebrows?

I began using subcision to elevate indented scars 21 years ago.  The very first patient that I ever treated with subcision was a 23 year old male of Far Eastern Indian descent with a diagonal traumatic scar between his eyebrows that had been present since age two. After one treatment session with subcision, the base of his scar was completely elevated up to being flush with the surrounding normal skin and both he and his mother who had been responsible for the injury were thrilled--as of course was I. Since then I have literally performed thousands of subcisions for all kinds of scars, including acne scars, chicken pox scars and post surgical scars. In general, subcision usually requires a series of between two to four treatment  sessions spaced at a minimum of six week intervals for achieving an optimal result. Since the success of the treatment depends upon the patient producing his/her own native collagen (neocollagenesis), the six week intervals are needed to allow the person sufficient time to produce this collagen in response to the procedure (which in the case of a scar of this size should take no more than three minutes to perform using only local anesthesia.) Once the scar is raised, if desired, any surface irregularities in texture and tone can then be treated with medical microneedling (aka fractional microneedle resurfacing) to blend the area better with the surrounding skin.For more information on subcision and medical microneedling, check out the archives or Realself.com and be sure to seek consultation with a board certified physician with expertise and experience in scar treatments. And be sure to ask to see his/her before and after photos. 

Contour scars on the forehead can be improved with fractional laser, sublative Ematrix, and subcision. All of these approaches can help improve scar visibility. Best, DR. Karamanoukian Los Angeles

this can be treated very well with a combination of treatments including laser, subcision and filler.  I suggest seeing a laser and scar expert for an evaluation.  I tell people there is no cure scars but I have treated many like this and have gotten 75-100% improvement with non invasive options.  I would suggest avoiding any surgical options as there is a chance for a larger scar.  Best, Dr. Emer.

This scar should be improved with a combination of subscision, fractional laser and possibly filler. Post-traumatic scars are treated with an approach that is similar to acne scars, chicken pox scars and post-surgical scars. My starting point is typically subscision, performed under local anesthesia, whereby a very thin needle with a scalpel-type end is inserted into the indented scar and this tissue is "loosened" through a gentle back and forth motion. New collagen is laid down in this area, helping to fill the indented area. This process takes about a month or so and I anticipate several sessions. If the improvement is incomplete, the sharp edges of the scar can be "blurred" with fractional laser or microneedling. Fillers such as Juvederm are helpful as well. Although they are temporary, they tend to last longer as compared with injections in sites such as lips and melolabial folds (perhaps because scar tissue is densely collagenized).Finally, there is emerging data to suggest that platelet-rich plasma (PRP) infusion, in combination with fractional laser, can improve acne scars. PRP helps to regenerate collagen and soft tissue though local infusion of platelet derived growth factors.* The statements above are not intended as a replacement for authentic medical advice; an in-person medical visit with a formally trained dermatologist is recommended.*Kenneth W. Alanen MD,Dermatology FRCPC Fellow, American Society of Dermatologic Surgery, Mohs' Micrographic SurgeryDermatopathology ABD / ABP, Fellow ASDP