Q: Dr. Eppley, I am interested in a non-straight line scar revision. Attached are some pictures of my facial scar.. I marked up some pictures with a horizontal line showing how it is raised on the side of the scar nearer my nose. Do you think that it would be possible to remove the raised skin on the inside of the scar near my nose or do you not think that would be necessary. My goal would be to smooth it out as much as possible where we could get rid of raised part as well as indented part on the incision line if possible. Note I am happy with how narrow the incision line is, I’m just not happy with how raised it is around the incision and I’m wondering if you think that a GBLR might break up the line to make it less obvious or if you think I should just try dermabrasion first to smooth it out. Also do you think a GBLR would be best or a straight line closure in the area of the cheek? I think the scar size is around 2 and a half cm in length.
A: Your prior straight line scar revision demonstrates the drawback of this approach in a facial area that does not parallel the relaxed skin tension lines. The scar line may be narrow but the edges around it are raised and visually obvious. With geometric broken line closure, the scar is also narrow but the edges do not usually get raised as the scar line is interdigitated and the contractile forces on it are better dissipated.
Dr. Barry Eppley