Sunken Facial Scar Need Advice for Improvement/Removal? (photo)

I have a 10 year old sunken scar from a botched punch excision for a pox scar from a Dermatologist. After the original excision was performed the sutures spread apart and created a worse sunken scar. I went back to him again 6 months later and he re-excised the area creating an even larger scar. I stopped there hoping time would heal but it hasn't. No internal sutures were used which I have read are necessary for my high tension area. Willing to do anything for improvement.

Doctor Answers 2

Scar treatment may require combination approach

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Scars in areas of movement like yours in the frown line area may improve with a combination of Botox, laser resurfacing, and filler.  Botox will relax the muscles that accentuate the scar when you frown.  An ablative fractionated Erbium or CO2 laser will improve the superficial textural changes of the scar.  Filler like Restylane or Juvederm can fill in the depression associated with the scar as long as it is distensible (meaning it flattens out when the skin around it is stretched); this area needs to be treated very carefully with filler because there is a risk of blood vessel compression causing skin damage.   I think the last resort would be reexcision with appropriate deep sutures, although this would depend on your consultation exam.  I hope this helps. 

Greenwood Village Dermatologic Surgeon

Scars can be improved with a variety of approaches

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I think there are a few different approaches that may benefit the appearance of your scar. Lasers would certainly be one option that can smoothen out and decrease the sunken appearance of the scar tissue. Another approach would be to take a small amount of fillers (what we use to make wrinkles smoother) and place that underneath your scar tissue to prop it up and that can also lessen the sunken in appearance you mention. I would advise seeing a dermatologist that has completed fellowship training in skin surgery and laser surgery as they have advanced training in surgical procedures of the skin. Good luck.

Omar Ibrahimi, MD, PhD
Stamford Dermatologic Surgeon
4.9 out of 5 stars 28 reviews

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