How would you treat the long indented scar on my forehead from a car accident 25 years ago? (photo)

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

Laser treatments and/or a series of microneedling or subcision would be needed for this.  You will get improvement but may not get complete removal, as this is a scar.  A cosmetic dermatologist or plastic surgeon with experience in scar treatments is needed.  We would gladly see you in our office.  I wish you the best of luck, Dr. Emer.

Your scar runs vertical which is the opposite to natural lines, that is part of the problem. The depression means that the underlying tissues, possibly muscle, is not properly approximated. So, what you need is a scar excision then multi layer closure to fill the depression and finally an irregular Z-plasty closure to break up and thus optically camouflage the scar. Any other treatment, such as lasers, would only give you some improvement at a high cost. Wish you the best.

Your scars can be improved with a series of laser treatments. Seek the expertise of a dermatologist with advanced training in lasers. In your area, I would consider seeing Dr. Suzanne Kilmer, she has great experience with this type of procedure.

I do think that there is siginificant mprovement that can be achieved with your forehead scars.  A scar revision procedure that would involve excising the old scar and using advanced plastic closure techniques such as serial Z-plasty, geometric broken line closure could giv e you dramatic improvement in the color, countour and orientation of the scars. I will often recommend resurfacing (i.e., laser or dermabrasion) the revised scar   at 8 weeks after the initial scar revision.  Fillers would only be necessary if any areas of the scar remain depressed relative to the surrounding normal skin, which would hopefully be avoided.