What method is the right one to treat the depressed scar on upper lip? (photo)

Before investing in something expensive like fractional laser treatment (Fraxel, Active FX), meet with a careful dermatologic surgeon or plastic surgeon to discuss the use of fillers and a technique called subcision to raise a shallow scar on the face. Subcision involves using a needle to cut the fibrous layers under the skin to make a tunnel that can heal with new collagen, or be filled with a hyaluronic acid filler like Restylane or Juvederm. A few rounds of this will likely smooth out many light to moderate scars.

Your scar is well oriented and about as narrow as could be expected following a surgical excision.  Therefore, I would direct my efforts away from any further cutting, as you would probably end up with the same result.  You could try fillers to raise the depressed scar.  Often this can be combined with subcision, a technique of sweeping away the scar tissue under the the depressed area with a microscalpel.  Sometimes this results in a permanent correction.  Otherwise, a more permanent graft can be placed under the skin.  These procedures must be done very meticulously, and your results will be very dependent on the experience and talent of the cosmetic surgeon.  Finally, some patients will need a secondary treatment with Carbon Dioxide Laser resurfacing.

If you can not find a surgeon very experienced in the most modern scar surgery techniques, you are better advised to leave this alone.

Yoash R. Enzer, MD