Can an indented scar be removed?

Subcision and/or scar excision with layered closure are both options to improve an indented scar on the leg or body. 

 

Raffy Karamanoukian, Los Angeles

In the past, if a person had a depressed (dented, or indented) scar  there were only two approaches to dealing with it.  One was to live with it, and the other to surgically excise the scar and revise it. The hopes here would be that the resulting scar would be less obvious than its predecessor.

Today, several additional, much less aggressive, approaches are available for treating scars that may have arisen from accidents, surgery, or infection. One method, known as dermaspacing, involves the insertion of a sterile needle-like cutting device below the scar to break up the thick bands of fibrotic collagen pulling the skin downward. In addition to releasing the skin above, this technique stimulates the production of new and healthier collagen to provide further support and lift. Generally a series of one to four treatments at six week intervals are needed for optimum improvement. 

A second technique,  medical microneedling or microchanneling, employs a roller to which rows of microneedles are attached. The microchannels created within the scar as the roller passes back and forth sets up a wound healing process that can result in new collagen production and improved appearance of the scar. Again, a series of one to four treatments may be needed at six week intervals.

Both dermaspacing and microchanelling take only minutes to perform under local.

If additional improvement is desired after either of the above, I have found that the injection of a small amount of a volumizing agent, such as Radiesse or Perlane Ultra XC, may contribute to further smoothing and leveling of the surface of the scar. 

It is not likely that the scar can be completely removed but it may be able to be improved via excision or revision.

Depressed or indented scars can be improved by various techniques. The scar may be revised with plastic surgery to remove or reposition the scar. Volume can be added to the skin with fat grafting to plump the depressed or indented areas. As plastic surgeons have already stated, scars can never be completely eliminated. Speak with a plastic surgeon to help determine appropriate options for you.

I would not recommend any treatment unless you can live with a poor result. The risks are high. Be careful out there.

No scar can be erased but the odds are that with a well-done scar revision your scar can be transformed into a much less obvious flat scar.