Forehead scar removal with autoimmune disease? (Photo)

Question

Would anyone revise a 0.5-inch circular atrophic scar in the middle of someone’s forehead with running mattress sutures? In the past, I got spitting sutures with PDS and, if possible, don’t want to use buried sutures. Some surgeons are saying that buried sutures are necessary for tension removal in this area; others are saying that they aren’t necessary. Long story short: I have autoimmune conditions that impact wound healing and reactivity to sutures. Lasers and filler haven't worked.

Nelson Lee Novick, MD · Answer

I am not surprised that the laser treatments did not work as I have been warning my regular followers for years that these gizmos are expensive "smoke and mirrors" devices whose hard science to support their use lags woefully behind the heavy marketing and social media hype to promote them. 
Revision surgery in an area such a the forehead, which is subject to a great deal of static and dynamic tension from the underlying muscles has an increased chance for the subsequent development of stretch scars and tram track stitch marks.
Subcision, which I have been performing since 1995, is an all-natural, minimally invasive means for elevating and smoothing indented scars from all causes. And once the scar is elevated, any residual, surface color and/or texture irregularities can be addressed by the use of manual Dermastamp microneedling--another perfectly natural minimally invasive technique that I have been using for nearly 25 years and also has a proven track record for safety and efficacy in all skin types. 
You would be wise to consult with a board certified cosmetic dermatologist scar treatment specialist and be wary of unproven and expensive light and energy-based treatments and of revision surgery, particularly in this region. Hope this helps and best of luck.

Forehead scar removal with autoimmune disease? (Photo)

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