5 days since primary closure of forehead cut, is Botox recommended to lessen scar widening? Scar revision rec? (Photo)

Head hit ground or the first step of a staircase; 1.25" length oblique cut to centroid of forehead resulted. Nonabsorbable sutures w/ basic technique by a physician's assistant, so I presume wound edges were not everted. Been 5 days since the cut was sutured; removal tomorrow morning. Is Botox as an adjunctive measure to minimize scar widening recommended now and how long does this option remain open for me? Worst case scenario, what scar revision technique would you recommend? Z/W-plasty/GBLC?

Doctor Answers 13

Fraxel Laser For Facial Scars

Thank you for your question. Ideally, Botox should be performed immediately after the healing in order to avoid and prevent the scar from spreading. I use Fraxel Laser for scars, which works great for improving the tone and texture along with the appearance. This laser treatment usually takes six to eight weeks for skin improvement, but you will see outstanding results! 

New York Dermatologic Surgeon
4.3 out of 5 stars 17 reviews

No treatment indicated

Horizontal, even if not perfectly straight, incisions, whether from trauma or surgery, heal remarkably well on the forehead.

Follow the plan and give it time.

My guess is 9 to 12 months from now your scar will be barely visible, if at all.

There is no need for you to have a scar revision. Certainly the decision should not be made within 9 to 12 months.

Z-plasty would most likely be an inappropriate form of scar revision on the central forehead.

Skip the Botox for now. My guess is it may make things look awkward until the Botox wears off.  

Best of luck,

Mats Hagstrom, M.D.

Mats Hagstrom, MD
San Francisco Plastic Surgeon
4.8 out of 5 stars 18 reviews


Botox can be used to help with scars especially if there is a significant amount of muscle tension on the wound edges or if there is a lot of underlying movement, like around the mouth. I think best would be to give a chance to heal first. then you can consider scar revision and or lasers etc to make it better

Misbah Khan MD, FAAD, FACMS
New York Dermatologic Surgeon
4.9 out of 5 stars 28 reviews

Botox to help with forehead healing

Thank you for the photo and your question. I hope you're healing well! First, you are lucky in that your injury runs parallel to the forehead lines -- this will help the overall camouflage after healing. Second, the main thing to do is to follow directions from your doctor regarding activities and would care. Third, avoid getting any sun on the area, as this can make the scar more pigmented than the surrounding skin. Lastly, if you have a lot of forehead movement, small doses of Botox could help to reduce the tension on the wound. Best of luck!

Evan Ransom, MD
Bay Area Facial Plastic Surgeon
4.9 out of 5 stars 110 reviews

Leave it alone for now

At this time, I think you should let your scar heal better and apply a silicone gel or silicone sheeting. Then, at a year or so, you can consider scar revision. Fillers may help to even out any indentation. I've also had success with microneedling.

Jerome Edelstein, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 176 reviews

Botox for new scars?

Wow, another use for Botox?! Theoretically, an interesting premise, but I have seen no research to back that up. Put that Botox money into a good scar cream and moisturizer! Massage the scar twice daily with moisturizer and use the scar cream at night. Because the scar is lined up parallel to the normal lines of your forehead, you have an excellent chance of a good scar. Good luck and also seek the advice of a plastic surgeon.

Robert M. Tornambe, MD
New York Plastic Surgeon
5.0 out of 5 stars 28 reviews

Botox for forehead scarring?

I do on for think Botox would be of value. Whenever the skin is cut full thickness there will be a scar. Fortunately your wound is parallel to and not perpendicular to the lines of tension in the forehead. It is much too early to be anticipating the need for scar revision.  Stay out of the sun and understand that the wound will do through an inflammatory stage before it heals. Full healing takes up to a year so a lot of patience is required.

Robert L. Kraft, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 40 reviews

Laceration , #BOTOX , healing #wound

Dear Islack

Thank you for your question and photo!  OUCH! Hope you are feeling better.  If you have a lot of forehead movement- you raise your eye brows and make forehead lines- then weakening the forehead muscles may minimize the scar ( a fold/line can sometimes be created in the scar/wound ) by decreasing the movement of the frontalis muscle.  The BOTOX would work for 3 to 4 months in the critical time of healing and may not need to be repeated.  As for a revison- hopefully you will not need one!

With Warm Regards
Trevor M Born MD

Trevor M. Born, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 115 reviews

5 days since primary closure of forehead cut, is Botox recommended to lessen scar widening? Scar revision rec?

Based on the orientation of your scar I don't think that Botox would be of much help as the contraction of your forehead muscles would actually push the edges together and therefore reduce tension across the wound. In terms of scar revision it is way too early to tell. Get your sutures removed as planned and then use a high quality scar gel as directed for 3-6 months. If you still think your scar is problematic after 6 months then it is worth having a consultation with a board-certified plastic surgeon to see if there would be any benefit to a scar revision. Best of luck!

Mathew A. Plant, MD, FRCSC
Toronto Plastic Surgeon
4.9 out of 5 stars 30 reviews

Reduce tension and scarring of wounds - Botox ?

There are surgeons who inject Botox around healing wounds, especially those like the forehead where there is contraction of the forehead muscles. 

Your scar is along a line pperpendicular to the line where contraction occurs - therefore, the Botox would not help much. If the scar were oblique or up and down the forehead, Botox may help reduce tension by freezing the muscles. 

Save your money for a revision, if needed, in 6 months. 

Hratch Karamanoukian, MD, FACS
Buffalo Phlebologist
4.8 out of 5 stars 41 reviews

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