Treatment for Indented Surgery Scar?

Question

I had a Mohs surgery three months ago just under my eye. The surgeon said the wound was not deep and didn't need stitches; it would heal without a mark. Instead,  It left me with an indented scar.  Is there any treatment to encourage the skin to fill in?

Vincent N. Zubowicz, MD · Answer

I think fillers under depressed scars a futile.  The scar is just too rigid to elevate.  Therefore a scar revision is indicated in most circumstances.

Raffy Karamanoukian, MD, FACS · Answer

Indented scars do well with reexcision or subcision.  Speak to your surgeon about surgical scar revision when the risk of recurrence is low.

Stephen Weber MD, FACS · Answer

Contraction and depression of wounds left to heal by "secondary intention" (left open) is not uncommon. Depending on the severity of the problem something as simple as massaging the scar daily can be helpful. This will help minimize edema (swelling) and might flatten the tissue surrounding the scar. Dermabrasion can help lower the surrounding skin and reduce the shadowing that reveals depression of the scar. Dermal fillers can help plump up the scar itself. Lastly, the scar can be removed and repaired with local flap - essentially starting over with something similar to but smaller than the original wound.Stephen Weber MD, FACS

William Ting, MD · Answer

The atrophic nature of your scar is due to contraction of surgical scar. Filler injection to replenish the lost volume would be the best, instantly gratifying option for depressed scar particularly along tear trough areas. In the hands of an experienced board-certified dermatologist or plastic surgeon, a variety of fillers can be considered, e.g. Restylane, Juvederm, or Evolence Breeze.

Boris Volshteyn, MD, MS · Answer

It is quite common to heal after MOHS surgery without sutures.  Actually in some places on the face the opening heals better if it heals this way.  Without knowing the location and type of cancer treated, I would not jump to revision right away.

	3 month is a very short time.  Indentation you see may be more noticable while there is still surrounding swelling and as it subsides, you may not need any additional surgery.

	I would wait till 6 month after surgery and then discuss with your MOHS surgeon options for revision if needed and any contraindications based on the type of cancer removed.  There are some studies showing better survival of patients with advanced melanoma and decreased recurrence if the wound heals by secondary intention.

	Sincerely, Boris Volshteyn MD

Treatment for Indented Surgery Scar?

Answers (5)