Could My Cheek Scar Be Improved By Geometric Line Closure?

Q: Dr. Eppley,  Attached are the pictures of my scar on my cheek. What bothers me the most is the indentation. I would like to get surgical scar revision as I’ve tried lasers etc and nothing has worked. Do you think I’d be a candidate for scar revision?  My scar is 6 years old or so. It looks red in some photos as I had a tca peel done a few months ago, which didn’t help with the indentation. I was interested in finding out what you would think would help? I read up about geometric line closure correction do you think this would be more favorable than a single line surgical scar? Let me know your thoughts, Thanks so much.

A: Thank you for sending your pictures. Given your scar’s appearance, I would think the only possible improvement for it would be geometric scar revision. Scar indentations can never be improved by very superficial skin treatments like chemical peels or even laser resurfacing. The entire scar must be excised and normal tissue brought together over the indented area. By the perimeter shape of the scar, it would be brought together in a geometric pattern, merely its irregular shape from the beginning. While one could make an argument to do a wider elliptical excision of it and close it in a linear or straight line fashion given is parallel orientation to the nasolabial fold, I would initially prefer a geometric approach which would also produce less total scar size.

Dr. Barry Eppley