3-yr-old daughter's gash on her forehead was repaired in the E.R. but after healing, the scar is wide and looks terrible (Photo)

Question

My 3-yr-old daughter's pediatrician sent her to the E.R. for a repair of a gash on her forehead.The on-duty physician said there was no need to use a plastic surgeon and used Dermabond and a steri-strip to close the wound.After 2 wks. the wound looks terrible with a depression between the wound edges.Should the dr. have used stitches? When should we consider scar revision? Will a scar revision make the scar look as good as it would have looked if it had been repaired correctly the first time?

Raffy Karamanoukian, MD, FACS · Answer

Plastic surgery scars require attention after surgery so that they remain cosmetically-appealing and barely noticeable. In our office, we use a protocol for scars that minimizes their activity in the 6-8 weeks after surgery. If you have late plastic surgery scars, you may also require laser and RF therapy to help reduce the longterm effects of the scarring. Keloids, hypertrophic scars, widened scars, red scars, and hyperpigmented scars all require scar modulation with topical creams followed by lasers and RF therapy. Topical skincare should be directed to a specific need, whether for pigmentation or hypertrophy and our office can guide you through the process to obtain the correct Plato’s Scar cream or Melarase cream for hypertrophy and discoloration. In terms of lasers, we would employ the vbeam laser for redness, Venus Viva RF, PRP microneedling, chemical peels, and Morpheus 8, fractional erbium, or fractional co2. All of these have their individual benefits. Most of all, we recommend you visit a solid plastic surgeon who understands surgical scar revision, laser therapy, and RF therapy for scars. 
 
Best, 
Dr. Karamanoukian
Realself100 Surgeon

Jason Emer, MD · Answer

This likely need sutures and could be revised.  However, if that is not possible at this time, wait 3-6 months to reassess the healing and consider laser treatments.  Likely it will heal fine.  Best, Dr. Emer.

Stephen Weber MD, FACS · Answer

It is always difficult to second guess the treatment of the doctor that cared for your doctor. With that said, Dermabond can work great but typically requires a layer of sutures beneath the skin to approximate the skin edges and remove the tension from the skin closure. This scar will improve for up to a full year. Laser treatments can be performed as early as six weeks in many cases. Most often, with very young children it is best to treat these wounds topically and reserve and invasive/ painful treatments until they're older and can tolerate treatment in the office with local anesthesia. I hope this information is helpful for you.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

J. Jason Wendel, MD, FACS · Answer

Thank you for your question and pictures.  The wound appears to be well approximated.Once this wound heals and the steristrip and Dermabond are off, you will want to use moisturizer, protective sunscreen, avoid prolonged exposure to the sun and scar massage. Silicone sheeting or Silicone Gel can be helpful.I have included a web reference for scar care instructions for your review.To be sure, see two or more experienced, board-certified Plastic Surgeons for a complete evaluation.I hope this helps.

Brian S. Biesman, MD · Answer

Thank you for your question.  I am sorry to hear about your daughter's accident.  I would recommend evaluation by a surgeon who is skilled in cosmetic and reconstructive surgery of the face to determine your next best step.

3-yr-old daughter's gash on her forehead was repaired in the E.R. but after healing, the scar is wide and looks terrible (Photo)

Answers (5)

Answer: Scar Removal

Answer: Scar Removal

Answer: Treatment of a scar on the forehead

Answer: Treatment of a scar on the forehead

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3-yr-old daughter's gash on her forehead was repaired in the E.R. but after healing, the scar is wide and looks terrible (Photo)

Answers (5)

Answer: Scar Removal

Answer: Scar Removal

Answer: Treatment of a scar on the forehead

Answer: Treatment of a scar on the forehead

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Recommended reading

Everything you need to know about Scar Removal

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