Atrophic scar / crater from mole removal. How can this be minimised? (Photo)

Question

It's been six weeks since a small mole was removed from my temple near my eyebrow by surgical excision by a plastic surgeon. I've been diligent about massage and silicone tape everyday but a huge crater/divot has formed where the stitches used to be - it looks very indented. I'm not worried about the pigmentation (I know that will go). But how do I minimise further indentation/ encourage it to fill in? Will silicone and scar massage worsen it?

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

Depressed scars can be improved with vascular lasers like Yellow laser, BBL, or Excel V when they are red --- and with CO2 spot treatments, fillers, microneedling with PRP, and subcision to help with texture and blending. I recommend getting a formal evaluation with a scarring expert. Best, Dr. Emer​

Nelson Lee Novick, MD · Answer

I'm sorry you are experiencing this. Massage for indented scars and silicone tapes and gels in general are not particularly effective. I typically recommend Scalpel Sculpting for the cosmetic removal of moles, even flat ones, since it does not involve any deep cutting nor the placement of stitches, which, particularly in areas subject to muscular tension or movement are likely to give rise to stretch scars and tram track stitch mark scars. Between weeks eight to twelve, before a scar has fully matured, is a fortuitous window of opportunity to treat an evolving scar. Make sure to consult with a board certified cosmetic dermatologist and best of luck.

Reuel Aspacio, MD, FAAD - Account Suspended · Answer

Thank you for your question and photograph. It's difficult to evaluate your skin through this type of forum. Treatment options that cause injury to the skin creating subsequent collagen formation is effective for atrophic scarring such as laser therapy, microneedling, etc. In some cases, injectable fillers are an option. I highly recommend you consult with a board certified dermatologist or plastic surgeon to discuss appropriate treatment options that best suit your needs. Take care and good luck.

Atrophic scar / crater from mole removal. How can this be minimised? (Photo)

Answers (4)

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