Indented Shave Biopsy Scar on Cheek @ 4 Months, Treatment Options? (photo)

I had two shave biopsies done for potential skin cancer (both turned out benign). Both were done on the cheek area; the less visible one is healing flat and even but the one done right in the middle of my cheek was shaved too deep and now it is a huge indent with the surrounding areas slightly raised. I have looked into subcision and scalpel excision. Basically, I want a procedure done that will result in a FLAT barely noticeable scar. What are my options here? Recovery time? Thank you! :)

Doctor Answers 2

Shave biopsy depression

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First, it is important for you to allow the biopsy site to heal completely, which would be about one year after the procedure. Any surgical revision would involve creating a much longer, elliptical incision which would result in a longer scar. Truthfully, the biopsy was necessary to rule out skin cancer, which would have required a formal excision. Believe me, everyone wants a flat, unnoticeable scar but sometimes that isn't in the cards. Be patient and let it go on to heal to the maximal extent before rushing into a procedure.

Nonablative resurfacing for indented scar

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I'm sorry to hear about the indented scar.  I think it would be worth trying a series of nonablative fractional laser treatments (1540 or Fraxel) spaced 4 weeks apart (4-5 treatments total).  This will help build collagen within the depressed area and also improve the color changes associated with the scar.  The last resort would be excision and re-approximation of the edges that would, of course, result in another scar that would hopefully look better over time.  Subcision is not effective for this type of shave scar.  Subcision is useful for acne scarring where there are adhesive bands tethering the skin to the underlying tissue.

Michael Contreras, MD
Greenwood Village Dermatologic Surgeon

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