Can the appearance of this depressed/indented scar be reduced? (photos)

Question

Last April (2017), I accidentally lacerated a portion of skin next to my right eyebrow from the recoil of a rifle scope. I received 6 stitches from a walk-in clinic on the same day. Over time, the scar has widened. The scarred skin is also depressed, making it more noticeable. I was wondering what my options are for reducing its appearance? Is this a difficult area of the face to repair and might the scar widen again, especially with the various facial muscles in and around the area? Thank you.

Raffy Karamanoukian, MD, FACS · Answer

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

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Jason Emer, MD · Answer

this type of scar can be improved with lasers, dermabrasion, fillers and peels. I suggest you see an expert.  Microneedling long term can give improvement too but would take numerous treatments.  Best, Dr. Emer.

Nelson Lee Novick, MD · Answer

When it comes to to depressed scars from all causes, acne, chicken pox, post-surgical and, as in this case, post traumatic, to achieve maximal improvement, two problems typically need to be addressed, The first, and often the most troublesome, is the depression itself, which gives rise to the shadowing "craters of the moon"-like effect that makes the scar that much more prominent. The second problem is that once elevated and more flush with the surrounding skin surface, scars still may remain visible since they are characteristically off-white or ivory-colored. Subcision is a simple, quick, and relatively inexpensive approach to elevated the depression itself. Microneedling, especially if accompanied by the topical application of tyrosine and lanatoprost can help to repigment the scar tissue and better blend it with the surrounding normal skin. I do agree with your concern that surgical removal might result in a stretch scar do to the muscular forces in that region. Best to seek consultation with a board certified aesthetic physician and make certain to ask to see his/her before and after photos before agreeing to proceed. Best of luck to you.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  Based on
your photographs, you may benefit from a surgical scar revision of your eyebrow scar.   Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results.   The most
important aspect is to find a surgeon you are comfortable with. I recommend
that you seek consultation with a qualified board-certified plastic surgeon who
can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.  FACS
Harvard-trained plastic surgeon

Daniel Barrett, MD · Answer

Dear verari,the is a number of different treatment options for scars, such as laser treatment, microneedling, subcision, dermal fillers, etc. If you are considering a treatment, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Gabriel J. Martinez-Diaz, MD, FAAD · Answer

certainly it can. seek the expertise of a board certified dermatologist - particularly with an interest in aesthetics and or procedural dermatology

Kristine Brecht, MD (license suspended) · Answer

Yes, there are several approaches to fading the scarring.
Microneedling and fillers, or excision followed by microneedling once healed.
Choose an expert. Best. Dr Brecht
Seattle, Wa

Can the appearance of this depressed/indented scar be reduced? (photos)

Answers (7)

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