How can I correct depressed scar on bridge of nose? (photo)

Depressed scar on bridge of nose as a result of a piercing. 7 years of age. Is it possible to excise it horizontally and reattach to surrounding skin, If that makes sense.

Doctor Answers 1

Fractional Medical Microneedle Therapy Following Subcision Works Well For Raising & Blending Depressed Scars

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When scars are fully matured, i.e. have been present for at least a year, as is obviously the case here, there are a variety of approaches that can be considered. For over twenty years, subcision has proven an easy and effective method for permanently elevating depressed scars of various types, including traumatic scars and acne scars.

Subcision is a procedure in which a sterilized needle is inserted, following the administration of local anesthesia, directly beneath a depressed scar (regardless of whether from acne, infection, trauma, or surgery) and used to break up the thick bands of fibrous scar tissue that bind down the surface and create the depression.

Breaking up the abnormal bands of thickened, scar collagen accomplishes two things. First, it allows the surface of the scar to float to the surface. In addition, the tissue fluid that immediately fills the space following treatment contains growth factors and other wound healing substances that promote neocollagenesis, native collagen production, that allows for improvement and elevation of the scars. Between two to four treatments, spaced at six week intervals, are generally required to promote sufficient new collagen to achieve a satisfactory improvement. Since, the collagen produced is one's own, the results of subcision are typically permanent. A small amount of collagen-stimulating volumizer, such as Radiesse, may be instilled right after treatment to further promote neocollagenesis (new, native collagen formation).

Fractional microneedle therapy aka medical microneedling (or dermarolling) works by creating numerous areas of controlled microwounding that set off in turn a cascade of events that result in new, native collagen synthesis, which translates into healthier, thicker skin that improves the appearance of the underlying scars. It is particularly useful for improving the surface tone and texture of skin to enhance blending with the surrounding normal skin.

I would certainly consider the above approaches before moving on to more aggressive surgical excision, which entails stitches and downtime and would likely also require an additional surgical procedure, scarabrasion (a form of dermabrasion) several weeks afterward to promote further blending of the resulting linear surgical scar. 

Consultation with a board certified aesthetic core physician with extensive experience in all forms of scar treatment is essential.

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