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

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

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!

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.

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.

Dear IslackThank 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 RegardsTrevor M Born MD

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!

This is an interesting question.  Botox has been shown to improve scar outcomes although it's still considered an "off label" application of the medicine.  Similarly ,  we use it pre laser to improve the outcome with Fractionated CO2 laser resurfacing in the area of the crow's feet.  The mechanism of action here is that if there is less squinting movement of the muscle, the new skin growing around the eyes post laser grows in smoother. With scars, it's best used to prevent movement in the area of the scar to allow the edges of the wound to have minimal tension.  If they are exposed to pulling actions that pull the edges away, there may be a wider scar an if action that pushes the edges together, it may be more likely to get a raised scar.   It is difficult to tell from a photo if using botox at this point will be helpful in your case and you should discuss this with your doctor.  Several topical agents have been shown to be helpful to reduce scarring during the healing time and after the sutures are removed, massaging the area to prevent and release bands of scar tissue can be very helpful, even with just coco butter, but discuss this with your doctor since he/she will know best how it was repaired.  More mature scars can be treated with various devices and lasers with good success in experienced doctors hands.I hope that helps and best of luck!

I have used Botox for years to help prevent movement in the forehead in exactly your type of facial laceration.  Botox absolutely helps stop the spread of this scar and minimizes the scar from widening. I put in "baby Botox" which are tiny amounts of Botox in this area to help solve this problem.  Please consult a board certified dermatologist who has a great deal of experience with Botox and facial scars for the best cosmetic results.

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! 

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.