Indentation from Shave Removal on Cheek, What Can I Do To Fix This?

Thank you for the photo - it is very helpful in answering your question. It is common to have a slight indentation after a shave removal. Hopefully, it will fill in over time. Right now, your scar is going through a "contraction" phase. It will continue to remodel for up to 12 months. I know this sounds like a long time, but it should get slowly better and better. I recommend starting scar massage at 8 weeks after a skin surgery - so you could start doing this. If it is still indented after 4 months, then you could consider having a filler, such as Juvederm, or Restylane, placed under the scar. Another option after 4 months, would be to have a punch excision done on the scar and brought together with a suture. Hang in there - and if you're willing, be sure to go back to the doctor that did the shave so that you can work together to make it look cosmetically right.

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

This may level out, but unlikely.  You may need to have an incision to remove the defect.  See a Board Certified Plastic Surgeon to evaluate the location for a suitable correction.

As has been stated, often such depressions will fill in as they heal.  If they fail to do so within a reasonable period of time, subcision is sometimes helpful.  Injection of fillers under the scar sometimes provides temporary relief while the healing process takes places.  Occasionally the scar requires excision and repair.  One way or the other it is usually possible to achieve an acceptable aesthetic appearance of a scar in this area. 

Many times we are left with unsightly scars which are indented after removal of skin lesions, traumatic injuries, or after surgical procedures.  Once the scar is allowed to "mature" for a period of 6-8 months it can be evaluated for revision.  Many times indentations can be fixed by filling them with fat.  Fat is harvested from the abdomen, packed in a syringe, and injected under the skin to fill the "void".  Ne further incisions are usually necessary.  It is an excellent procedure, and I have had much success.  Good Luck, Dr. Corrado

Sometimes simple massage or "pinching" the skin overlying the indentation multiple times a day for many weeks can improve the situation.  Sometimes subsicion or the injection of a dermal filler (or even saline) is helpful.  If it doesn't go away after several months, best to returh to the doctor who treated the scar or consult a board-certified plastic surgeon or dermatologist.

Dear Steph, I suggest considering a procedure known as "subcision", combined with a spot Dermabrasion or chem-abrasion. Your dermatologist/plastic surgeon can help you decide , after considering your skin type [ fair skin vs olive complexion]. A filler may be an option, after this maneuver[s]

After looking at the picture you have posted, it appears that the shave removal may have taken place recently.  If this is true, I would like to reassure you that this will likely improve with some good wound care and time.  My recommendation at this time would be good wound care.  I suggest taking one tablespoon of vinegar mixed with a pint (2 cups) of warm water and soak the area for 15min 2-3x/day.  Then place some vaseline and a spot bandage.  Keeping the wound moist is key for the best and quickest resolution.  It may be pink for awhile, but that will resolve.  Once it is completely healed, there still may be an indentation, but I would not make that judgement until at least a month or two from now.  There will be a lot of remodeling taking place.  

Good luck, and stick to the wound care.  I am sure it will improve much more than what we can see in the picture, but the wound care is critical.

DW

Dear Steph, Unfortunately I have seen this happen all too commonly.  If the biopsy goes too deeply into the middle (dermis) layer, the patient will be left with an indention.  During the first few weeks the skin has to grow back over the biopsy site.  Some patients can be red in that area for the first month.  However, now three months have passed, so it is getting more likely this indentation will be permanent.  I would still advise that you wait for at least 6-12 months before any intervention.  If the site is still indented, I have helped many patients with my FaSuLa scar revision surgery.  Basically, a small tunnel is make just under the scar, and a graft is placed inside this tunnel to elevate the skin so it is flush again with its surroundings.  You can read more about it on my website.  In my opinion it would not be appropriate to do fat grafting for your situation, because the problem is not with the fat layer- it is more superficial.

Good Luck,

Yoash R. Enzer, MD