Would filler help resolve appearance of bottom lip scar or would it make it look worse? (photos)

Hi! Thanks for sharing your photo and being so detailed about your scar—it really helps to understand the situation. Since your scar isn’t very deep but has become more noticeable over time, there are a couple of things to consider.

Filler:

In most cases, dermal fillers aren’t the first choice for surface lip scars, especially shallow ones. Fillers add volume, which can sometimes make a scar look more raised or uneven rather than improving its appearance.

Fillers are more useful if a scar is associated with loss of volume, like an indented or depressed area, but even then, results can be subtle on the lip because it’s such a small, mobile area.

Laser options:

Fractional CO₂ laser or Erbium laser can help improve the texture of the scar and smooth the skin.

Non-ablative fractional lasers (like Fraxel) can also improve appearance with less downtime but may require multiple sessions.

Sometimes a combination approach—laser to resurface the scar, then light filler or softening injections if needed—can give the best aesthetic result.

Other considerations:

Microneedling with PRP or chemical peels can help with subtle surface scars, especially if your goal is texture improvement rather than volume.

Protecting the scar from sun exposure is important because pigmentation can make it appear more noticeable.

So, in short: filler alone may not help and could make it more noticeable, while laser treatments or resurfacing techniques are generally more effective for improving lip scars like yours.

If you want, I can outline a stepwise approach that combines the safest, most effective options for smoothing lip scars.

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture. Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.

Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best,
Dr. Karamanoukian
Realself100 Surgeon