Options for Old Dog Bite Scar On Cheek? (Photos)

Thank you for sharing your photos and your story. Since this scar dates back to childhood, it has matured and healed in its natural way over the years. That being said, there are several options that can help improve its appearance and texture, even in adulthood:

Laser treatments (such as fractional CO₂ or erbium laser) can help smooth the texture of the scar and blend it better with the surrounding skin.

Microneedling or radiofrequency microneedling may stimulate collagen production and soften the appearance of the scar.

Dermal fillers can sometimes be used to lift indented scars and make them less noticeable.

Surgical scar revision is an option for more prominent scars. A plastic surgeon or dermatologist can carefully re-excise and re-close the scar to achieve a finer line.

Topical or injected treatments (such as corticosteroids or silicone gels) may help in certain cases, especially if the scar has raised or thickened features.

Since your scar is stable and longstanding, the best approach would depend on your skin type, the depth of the scar, and how much improvement you’re hoping for, whether subtle blending or a more dramatic change. While the scar may not disappear completely, many patients achieve a smoother and less noticeable appearance with a combination of these treatments.

I am really sorry that this happened to you.
After only about three months a scar is considered "mature." This scar is a very old scar, and unfortunately, even with the best of treatments or combinations of treatments available today, the optimal improvement in appearance that can be realistically obtained when treating mature scars ranges between a 60-80 percent overall improvement in appearance.
Since the scar appears deeply Indented, , I would strongly consider subcision to elevate and smooth it as much as possible. Following this, I would consider the use of manual, mechanical microneedling (no need for the added expense or risks of RF microneedling) accompanied by the topical application of Rx pigment enhancing agents, such as tyrosine and latanoprost, in order to blend the scar better in both color and texture with the surrounding normal skin.
I would suggest using a great deal of "buyer beware" caution when being hawked all kinds of expensive, supposedly "next big thing" light and energy-based devices treatments, since the hard science to back up the use of these "bells and whistles" gizmos unfortunately lags well behind the heavy duty marketing hype and social media buzz to promote them.
You would be wise to consult with an experienced, board certified cosmetic dermatologist scar treatment specialist. Hope this helps and best of luck.

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture. Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.


Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best,
Dr. Karamanoukian
Realself100 Surgeon