Raising / improving surgical scar on cheek - options? (photos)

Question

I had a pre-cancer (white) removed that was about 5mm in size and the surgeon convinced me that a bigger cut would allow the skin to be closed without a noticeable scar other than a fine line. After 12 months in shock its finally healed and I have a depressed surgical scar line down my cheek that is 5cm long. the scar itself is fine but its tethered down so in bad light it looks horrendous, like i have a groove in my cheek. I guess the solution depends on the cause? Is it tether down/subcision?

Raffy Karamanoukian, MD, FACS · Answer

Plastic surgery scars require attention after surgery so that they remain cosmetically-appealing and barely noticeable. In our office, we use a protocol for scars that minimizes their activity in the 6-8 weeks after surgery. If you have late plastic surgery scars, you may also require laser and RF therapy to help reduce the longterm effects of the scarring. Keloids, hypertrophic scars, widened scars, red scars, and hyperpigmented scars all require scar modulation with topical creams followed by lasers and RF therapy. Topical skincare should be directed to a specific need, whether for pigmentation or hypertrophy and our office can guide you through the process to obtain the correct Plato’s Scar cream or Melarase cream for hypertrophy and discoloration. In terms of lasers, we would employ the vbeam laser for redness, Venus Viva RF, PRP microneedling, chemical peels, and Morpheus 8, fractional erbium, or fractional co2. All of these have their individual benefits. Most of all, we recommend you visit a solid plastic surgeon who understands surgical scar revision, laser therapy, and RF therapy for scars. 
 
Best, 
Dr. Karamanoukian
Realself100 Surgeon

Jason Emer, MD · Answer

Depressed scars can be improved with vascular lasers like Yellow laser, BBL, or Excel V when they are red --- and with CO2 spot treatments, fillers, microneedling with PRP, and subcision to help with texture and blending. I recommend getting a formal evaluation with a scarring expert. Best, Dr. Emer​

Paul Mittermiller, MD · Answer

If the scar is tethered to deeper tissue, a surgeon could attempt to release the tethering using a needle and fat graft the area. If there is no tethering, you could simply try a small amount of fat grafting or filler to the area.

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