Hello I want to have a scar reduced since I know there is no way to completely get rid of it, I had it since I was in the first or second grade and I am twenty three now, so its been a while, I know their are sometimes complications with darker skin tones, and I also would like to know what are the best choices, laser, plastic surgery, etc., any comments and suggestions will be greatly appreciated, thank you.
Scar Revision on Forehead on Brown Skin? (photo)
Doctor Answers 3
Lasers can significantly improve scars
Current technology with lasers for scar revision is very good. Given the large size of your scar and it being on your forehead makes me less excited about excision and repair as i think the resulting scar would be unsatisfying to you. Fully ablative CO2 would likely leave a significant amount of pigmentation that would be long lasting with your skin color. I think your best bet would be a fractional ablative laser such as the fraxel Re:pair which is a fractional rather than completely ablative CO2 laser. If you wanted no downtime then a non-ablative fractional would be a good choice also. If the scar is thick then I recommend injections to reduce the thickness.
Improving the Appearance of a Depressed Scar
Great question. When a scar is depressed, as yours is, there are a couple of options to consider. Excising the old scar and carefully closing it with the edges everted should yield a more attractive cosmetic outcome. The scar in the forehead can be oriented such that it blends better with the natural lines and wrinkles on the forehead, usually horizontally (or vertically if it's lower, between the eyebrows).
The other option to consider would be the injection of filler, such as Restylane or Juvederm, underneath the scar. I have had really nice results in minimizing the appearance of depressed scars in patients who do not want to undergo scar revision and for whom the color of the scar matches the surrounding skin color. The effects are temporary but seem to be fairly long lasting (>1 yr) for this application. If you get nice results from these dissolvable and reversible fillers, you could consider something longer lasting in the future.
Most likely, after considering all the risks, benefits and alternatives, simple scalpel shaving to make it as flat as possible would be your best bet. CO2 resurfacing laser would be effective but cost significantly more.
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