Indented Scar from Punch Biopsy Just Under Eye. What Can I Do?

I had a 4mm punch biopsy on the top of my cheek just under the eye area 10 months ago. It was stitched with 2 removable stitches. It has healed with a dented area & there is a slight ridged line where I think one of the stitches was placed. Overall it looks like a circular indented large pock mark which I realy dislike due to where it is on my face. Would a scar revision correct this so it is more of a level line scar rather than an indented circle?

Doctor Answers 3

How do you treat indented scars?

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Any time the skin is cut, for whatever reason, a scar will form. Sometimes the scar is barely visible, while at others it can be quite obvious and not cosmetically pleasing. Indented (atrophic) scars are common and are often unappealing due to the shadows that form in it, thus making it more obvious. There are many options to improve these types of scars depending upon the location of the scar, the appearance of the scar itself, and the depth of the depression. Here are some of the possible options to improve depressed scars:

  • Subcision - a small blade is inserted under the skin to remove any attachments that might be pulling the skin down. Some scars are caused by tethering others are due to loss of tissue, for which subcision is not helpful. This is often used in conjunction with fillers (below)
  • Dermal (and sub-dermal) Fillers - One can inject Restylane, Perlane, Radiesse, Sculptra, and Fat under a depressed scar to elevate it. Most of these treatments are temporary, lasting months to one year.
  • Laser Resurfacing, Dermabrasion, and Chemical Peels - All of these options help to smooth out the edges of a depressed scar. It does not fill in the depressed areas and therefore should only be used for slightly depressed scars or those with an uneven surface (i.e. a ridge).
  • Scar Revision -Sometime simply cutting out the scar and restitching it will greatly improve the scar, which should heal with a fine line scar.

Boca Raton Dermatologic Surgeon
5.0 out of 5 stars 3 reviews

Fractional resurfacing or surgical scar revision both work for repairing indented scars

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Indented or atrophic scars are unappealing because of the contour change and shadowing effect that they create.  Surgical scar revision with a layered can certainly provide excellent results.  Another non-surgical option to consider, depending on the depth of the scar, would be the use of ablative or non-ablative fractional resurfacing lasers.  With a series of 4-5 treatments, these lasers can often soften the degree of atrophy and improve the appearance without surgery.   

Matthew J. Mahlberg, MD
Centennial Dermatologic Surgeon

Scar revision for punch biopsy site is a good option.

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Yes, from your excellent description of the punch biopsy site it sounds like a simple elliptical excision and layered closure of the indented scar would yield a better result than the current scar. By placing sutures under the skin in the dermis it will add a supportive foundation while the surface heals and be much less likely to result in a depression. 

Brian J. Lee, MD
Fort Wayne Plastic Surgeon
5.0 out of 5 stars 13 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.