Restylane for Indented Surgery Scar?

Question

I had surgery on my nose to remove cancer. It left a big indentation. Would you recommend Restylane for filling this in.  I have a few scars in that area also.

Ron Shelton, MD · Answer

Sometimes fillers do not lift indentations. The depressed scar may be held down by bands of collagen that you heal with underneath the scar. If the area is held down in this fashion, the filler might squeeze out to the surrounding skin and make that area look thicker and not change the depth of the scar but make it look deeper in contrast to the thick surrounding skin. Subcision is a procedure that can be done to lift the scar first and then a filler can be done. This works bettter if the edge of the round scar you have is smooth and not a sharp “cliff-drop” edge. If the edge is tapered or blends into the surrounding skin then the lifting will look better. The most important concern is not to do this until your physician is confident that all the tumor is gone! They may wish to wait one to two years, or more, after surgery before such revision

Tanveer Janjua, MD · Answer

You can use a filler such as Restylane, Juvederm or Radiesse to fill up the depression. However, all these are temporary measures. Silicon is a permanent filler but I do not use it. It can cause permanent granulomas (bumps).
Your best option is to undergo a flap reconstruction. In this procedure skin is borrowed typically from your forehead and moved down to fill out the defect. After 3 weeks the attachment to the forehead is removed. Later the existing scar can be sanded down by laser or dermabrasion.
Regards

Kenneth D. Steinsapir, MD · Answer

Betty
As you can see if your are hammer, the world looks like a nail.  We surgeons like to fix things with surgery.  However, filling depressed scars with Restylane and Perlane is very effective and does not require the expense, down time, and uncertainty associated with surgery. 
The hyaluronic fillers are very helpful for these small scars.  One can easily get 6 to 12 months of benefit from this type of treatment.  Since only a small volume is typically needed, your doctor can use the balance of the filler in other facial area such as the nasolabial fold.
Dr. Steinsapir

Brent Moelleken, MD · Answer

Fillers will give temporary relief.  We would prefer Restylane or Juvederm rather than semipermanent fillers, especially on the nose, which can form granulomas in some cases.
Finesseful, artistic reconstructions can usually done that will give permanent improvement by restoring the tissues lost to cancer by using tissues like the ones that were removed, all from the patient's own body. 
Board certified plastic surgeons with an interest in cancer reconstructions are ideal to consult with for this problem.

Farbod Esmailian, MD · Answer

Injections can be helpful but very unpredictable.
I would prefer to use something like Radiesse which is a bit thicker and more long lasting.  Restylane does not last that long and neither does juvederm.
Good luck.

David Shafer, MD, FACS · Answer

Injections can be very helpful no nasal deformities or contour irregularities. However, is all really depends on the quality of the scar and the softness of the surrounding tissues. However, Restylane or Juvederm and be very helpful to correct these areas. Good luck.

Kevin Ende, MD · Answer

Without seeing a picture of your nose, it is difficult to make a specific recommendation.  
However, filler products are often used to smooth out contour deformities and raise depressed scars on the nose.  
Radiesse is most commonly used in my practice, but other filler products are also acceptable.

Robert A. Weiss, MD · Answer

A depressed scar on the nose remaining after skin cancer can be elevated with a soft tissue filler such as Restylane. We have had good results with this. The results last for 6 months to one year but with repeat injection at 6 months we have found very long lasting effects (several years). The fact that it is such a non-invasive and straightforward procedure is a big plus. Studies have shown that Restylane results in collagen formation at the injection site which is indicative of longer term improvement.

Steven Wallach, MD · Answer

It sounds like you need a local flap for repair of the defect.  Although a filler can be used, it is temporary and in light of a previous skin cancer, it probably is not a good idea.

Sirish Maddali, MD · Answer

Consult a good plastic surgeon in your hometown, Betty. He/She will give you some great advice on how to improve your nasal scars and profile. Fillers can be very helpful in this situation and I prefer to use Radiesse in the nose due to its firmness and the fact that it lasts longer. However, Restylane or Juvederm could be very useful too. It all depends on exactly where the scars are and where the indentations are located. Good luck!

Restylane for Indented Surgery Scar?

Answers (11)

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