Forehead Scar Revision
Q: Dr. Eppley, I am interested in forehead scar revision. I was on Dr Eppley’s website and noticed a few pictures of a scar revisions he had performed with great results. Seeing that he has successfully treated similar scars in the forehead region I would like to see if Dr Eppley can help me with my indented forehead scar. My scar is a result of a scar revision done one year ago for an indented chicken pox scar. The scar is approx 1/2″ in length and it sits directly on my natural wrinkle line in the center of my forehead. Unfortunately the incision line is indented which results in an aweful shadow effect. Also at the one end of the incision there is small indented hole possibly caused by the corner of the incision opening up a bit early on.The plastic surgeon who did the revision used 3 buried dermal sutures and 6 exterior sutures however he said he did not evert the wound edges as he felt it was not necessary. No eversion plus possibly too much forehead movement during the healing phase resulted in what my scar looks like today. I have also had 1 dermabrasion procedure done to grind down the indentation appearance with very minimal results. If Dr Eppley can help minimize my scar it would be greatly appreciated. Thanks very much for your time.
A: In looking at your pictures I do believe your forehead scar could be improved by forehead scar revision. But I don’t think it is as simple as just cutting out the scar and closing it in a linear fashion…with or without wound edge eversion. While the scar needs to be re-excised and closed, the key element for sustained improvement is providing some structural support underneath the wound edges to prevent a recurrent indentation. This can be a small piece of fat, dermal graft from an old scar or even a piece of allogeneic dermis. (e.g., alloderm) This will create a mild temporary elevation of the scar which will settle into a flatter profile. But without adding anything to it the wound edges are likely develop recurrent indentation given the high muscle activity in the area.
Dr. Barry Eppley