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

Question

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! :)

Raffy Karamanoukian, MD, FACS · Answer

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Robert L. Kraft, MD, FACS · Answer

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.

Michael Contreras, MD · Answer

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.

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

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

Answers (3)

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Everything you need to know about Scar Removal

Our mission is to create a world where every investment in modern beauty is Worth It.