Options For Indented Facial Scar From Dog Bite? (photo)

Subcision is a procedure in which a sharp needle is inserted and fanned around under the scar (after numbing with local anesthetic). This technique breaks up the scar tissue and also allows for new collagen to be produced that flattens the scar and improves its appearance. In general, a series of procedures, usually two to four spaced at monthly intervals,  is required to achieve an optimal result. To further enhance collagen production and to improve the surface appearance and coloration, I would suggest two to four treatment sessions, at six week intervals, of medical microneedling with the Dermaroller. This procedure, which may be performed under local or topical anesthesia, also stimulates new collagen formation. But by breaking up the surface of the scar, it also allows for improvment in the surface appearance and for improvement in the otherwise ivory-like color of the scar

There are many options for indented scars such as the one shown in the photo.  Surgical revision followed by Fractional CO2 laser resurfacing would be an ideal treatment protocol in my own practice in Santa Monica.  I would also recommend pre and post treatment with Melaquin AM and Melaquin PM to enhance the results of the scar revision of the lips.

in my opinion, the very best treatment would be to simply excise or remove the old scar and make it a narrower line. This would be the best way to treat the scar for long term improvement.

I agree with the other comments. Sometimes resurfacing alone with the fraxel repair laser can be all that is needed but with deeper and wider scars, an excision (cutting out) of the scar immediately followed by fractional resurfacing is an ideal treatment.

Since the scar is relatively wide and depresses, a re-excision and meticulous repair  (scar revision) by a plastic surgeon should give you the best outcome. Treatment with scar cream and protection with high SPF sunscreen are also important.

As shown by the posted photos I agree with Dr Trimas. Re excision of the defect and layered closure would give the best chance of an improvement.