What is the best treatment for an indentation on my thigh due to traumatic injury? (Updated)

Question

I had a traumatic injury to my thigh that left an indentation that my doctor said was collagen loss. I am tanned Hispanic, female, healthy, have hypertrophic scars, early 30s. It has been a year. Updated: What is the best treatment(s)? Subcision, microneedling, lasers, RF, tretinoin? Do not want filler or anything artificial injected that is permanent. Would just like something to stimulate my body to build back the loss. Thank you

Raffy Karamanoukian, MD, FACS · Answer

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Daniel Barrett, MD · Answer

Dear XBa,
it is hard to tell for sure without an examination. Generally speaking, fat transfer is a good option for correction of dents. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Harold J. Kaplan, MD · Answer

Hello Xba.  There are a few options.  Surgically you could have fat transfer.  That is harvesting fat from one area of the body and moving it to another.

Non-surgically you said you did not want filler, but there are two other products, Sculptra and Renuva.  Depending on the size of the indentation, these are both possible options for you.  Sculptra is a biostimulator and it helps you develop your own collagen.  Whereas Renuva is an injection of a fat matrix that stimulates your body to produce fat in the area injected.  Both are much more long lasting than fillers, with Sculptra in the 3-5 year range and Renuva semi permanent (no FDA approval for permanent).

Nelson Lee Novick, MD · Answer

Subcision, which I have been performing since 1994 has a proven track record for elevating and smoothing indented scars by breaking up the tethering bonds that hold them indented and promoting new, more healthy and normal collagen and elastic fibers to replace the scar collagen. No fillers are required, nor is there any surface cutting, so that this procedure is safe and effective in all skin types. Make sure to consult with an experienced, board certified cosmetic dermatologist with experience in performing subcisions. Best of luck.

What is the best treatment for an indentation on my thigh due to traumatic injury? (Updated)

Answers (4)

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