How can I treat this horizontal scar between my eyes? (Photos)

Question

I've had a scar between my eyes. It was like a fold more, but with some hard scar tissue underneath. Not really sure how it got there, as I used to wear glasses. Post op, it was quite prominent. Went to a local plastic surgeon and asked for improvement. He made a 'boat shaped' incision removing some scar tissue, however the scar is still very visible, in fact it is worse. It has now been 14 months. It is in the 'fold' between the eyes (glabella?). My age is M36. This has been a big issue for me.

Raffy Karamanoukian, MD, FACS · Answer

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

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

Anil R. Shah, MD · Answer

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin - Winnetka & Chicago. This is a great question. I recommend CO2 laser resurfacing as one of the more effective options for improving the texture and visibility of mature scars, including those with thicker or uneven edges. This treatment works by precisely removing micro-layers of skin to stimulate collagen remodeling, which can help blend the scar more smoothly into the surrounding tissue over time.

Anna Chacon, MD, FAAD · Answer

Thank you for sharing your story—scars in such a central location on the face can be emotionally difficult, especially when treatment hasn’t led to the improvement you hoped for. It’s completely understandable that this has been frustrating.

A scar that remains visible 14 months after surgery is considered mature, and at this point we can look at treatments that focus on texture, thickness, and blending it better with the surrounding skin. Based on your description—a horizontal scar with some firmness beneath the skin—here are the most common and effective approaches:

1. Corticosteroid injections
If the scar is raised and firm, small steroid injections can help soften and flatten the scar over a series of treatments. This can make a significant difference in the appearance without additional surgery.

2. Silicone therapy
Silicone gel or silicone sheets are non-invasive and help soften and improve scar texture over time. These work best when used consistently for several weeks to months.

3. Laser resurfacing
Fractional CO₂ or Er lasers are commonly used for facial surgical scars. They work by smoothing uneven texture, reducing redness, and stimulating collagen remodeling so the scar blends in better.

4. Microneedling or RF microneedling
These techniques create controlled micro-injuries that help remodel collagen, softening the edges and improving contour. They are often effective for surgical scars on the face.

5. Scar revision (only if truly needed)
If the scar has poor alignment or tension from the original repair, a skilled facial plastic surgeon or dermatologist can sometimes re-excise and close it in a way that makes the final result more subtle. However, this should be considered only after less invasive treatments, especially since you’ve already had one revision.

6. Topical treatments
Prescription retinoids, onion extract gels, and growth factor–based creams can assist with remodeling, though these work gradually and are usually combined with other therapies.

Even after more than a year, scars can still be improved significantly—many patients see meaningful changes with the right combination approach.

You’ve already taken steps to address it, and while the first outcome wasn’t what you hoped for, there are still very reasonable and effective options to pursue without immediately turning to more surgery.

Nelson Lee Novick, MD · Answer

Simple subcision can be used to elevate and smooth the depression. Additionally, since the repetitive motion of the muscles of the glabella serve to perpetuate the scar in this region, the additional use of Botox can serve to soften this muscular motion, which, by softening this movement, would allow for a more optimal result from the subcision. You would be wise to consult with a board certified cosmetic dermatologist scar treatment specialist.  Hope this helps and best of luck..

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