What type of procedure could help the indentation of the scar on my nose? (photo)

I was bit by a dog as a child and it left a scar that I have had for 17 years. It is normally more red I've just applied some vitamin e. I have sensitive skin and this scar is indented it is very noticeable in natural lighting and really bothers me. I have no idea which direction I should take to improve it, but all I know is I need to do something to help with the indentation. Please help :(

Doctor Answers 2

Subcision, Fractional Microneedling Therapy, & Stimulatory Fillers Work Well For Improving Atophic, Traumatic Scars

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I have had several cases of dog bite scars to the nose in the course of my career. In such instances, I have personally achieved consistent and gratifying results using a combination of subcision, fractional microneedling therapy (medical microneedling) and, when deemed appropriate, the additional injection of a collagen stimulatory filler for improving depressed, atrophic acne scars, which appears to be the case here.

Subcision is a simple procedure that uses a needle-like cutting device that is slipped under the scar (under local anesthetic) and moved from side to side in order to break up the fibrous bands of scar tissue. This allows for the surface of the scar to float to the surface and also to promote new, more normal collagen synthesis to fill the potential space created. The result--a much more shallow scar and often significant visual improvement. A decided benefit to this approach is that the results are permanent, since the technique, as was pointed out, is predicated upon the person's own ability to produce new collagen in response to treatment.

When there is an unsightly surface texture to the scar, a series of medical microneedling treatments can be initiated. For relatively small scars, as in this case, the DermaStamp may be used. This is a small instrument with a series of sterilized needles attached, which may be used, under local anesthesia, to disrupt the surface of the scar, allowing it to reform in a more uniform texture and sometimes color.

Finally, if necesseary, the area under the scar can be volumized and smoothed, prior to treatment, by the injection, in a fanlike fashion, of a volumizing agent with a high lifting force. This not only gives immediate improvement by stretching and making more superficial the overlying atrophic scars, but also makes the fractional microneedle therapy, easier to perform. Here I prefer to use Radiesse or Radiesse combined with Voluma injected immediately under the scar to diminish more of that sunken or crinkly appearance.

Clearly consultation with a board certified aesthetic physician with extensive experience with all these treatment modalities is warranted.

Dr. Kimberly Henry

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Hello thank you for your question and photo! Sorry to hear about how you got your scar! I suggest you go to your local plastic surgeon to discuss options for scar revision, or other options such as using fillers. I'd love to see more photos with better lighting, full face, profile and 3/4 views would be great. I can give you better advice with better photos. If you'd like to send them to my private email, feel free, my website is drkimberlyhenry.com. Good luck!

Kimberly A. Henry, MD
Greenbrae Plastic Surgeon

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