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

Scar revision and percutaneous scar release will work well to reduce the appearance of your lip scar.

Concerned about depressed scar - re-excision, meticulous closure and dermabrasion should help. The scar is oriented relatively well with the wrinkles that we all eventually develop around the mouth. It is widened and somewhat depressed. If it doesn't particularly bother you, I would recommend leaving it alone. If it bothers you significantly, you should wait at least 12 months following the injury to pursue any treatment. The best option to improve this scar would be simple re-excision, eliminating tension on the wound and meticulous closure. Dermabrasion at 6 weeks in the office can then help the scar blend earlier. All of this can be performed in the office setting with local anesthesia.Stephen Weber MD, FACS

Treating a deprressed scar involves both filling the depression and surface of the scar to make it less noticable. I would recommend a combination of subcision with a Fractionated CO2 laser treatment called Deep FX. There will be some bruising and healing over a week and you may require 2-3 treatments for a best result. But the treatment should be extremely effective.

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