Will subcision fix my dented-looking forehead? (Photos)

Question

I'm at a loss for what to do. I used to have cystic acne and now I have a bunch of scarring on my face, particularly on my forehead. It's caused a rolling, dented look that I am extremely self-conscious about. I've asked around in Toronto and there are only a select few doctors who perform subcision on the forehead because of the risk of hitting an artery. Apparently I've got an artery running downwards right below the two largest dents. Am I not a candidate? Can something still be done? The scars are very clearly tethered. Please, don't sell me a bunch of quick solutions or filler. I need permanent, long lasting results, and I'm just coming off of maternity leave, so I don't have money for extras. Please help me.

Nelson Lee Novick, MD · Answer

First of all, congratulations on your baby.
I have been performing subcisions since 1995, when it was first introduced as a long-lasting to permanent solution to elevating and smoothing all kinds of indented scars, whether from acne, trauma, surgery, or infections (such as after chickenpox). The procedure originally involves the use of conventional needles to break of the scar tethering underneath, which allows blood (which contains wound healing and growth factors) to accumulate underneath the surface of the scar and stimulate the surrounding fiber-making cels (fibroblasts) to synthesize new collagen and elastic fibers and dermal matrix to fill the area and to provide the long-lasting to permanent improvement so desired. 
In more recent times, more aggressive types of cutting instruments have been introduced, which I do not use or recommend, because they risk causing excessive bleeding and even scarring. I have had to treat people who have come to me from all over the U.S. and Canada for complications of treatment with this more aggressive form of subcision.
Fillers have also been added by some physicians to subcision in order to provide additional improvement. But, these are optional. The concern in the forehead region comes primarily from the use of a filler, which may make its way into a blood vessel and cause potentially severe consequences, which is why I would not recommend this when performing subcisions on the forehead. However, conventional subcision with an appropriately sized needle and no filler, presents little risk, except for bruising, which is temporary. 
You would be wise to make sure to consult with an experienced, board certified cosmetic dermatologist scar treatment specialist with extensive experience in performing subcisions. 
Best of luck.

Will subcision fix my dented-looking forehead? (Photos)

Answers (1)

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