Q: Dr. Eppley, I want to ask about how to get rid of a facial scar. I want to fade or remove my scar in my face on my forehead. That scar was caused by a car accident in 1998. The characteristics of the forehead scar are flat, vertically-oriented above my right eye, its size is 33mm in length and 2.5mm in width. The color of the scar is darker (more red) than surrounding healthy skin. It tends to be flat and is slightly less irregular but, when my facial skin is flexed, the edges of the scar tissue can be unified. What is the best way to repair my scar? Thank you very much.
A: Your scar description describes perfectly that it is best treated by a formal scar revision. This scar revision would include total excision (cut out) of the scar and a geometric closure. (irregular or broken line closure) The appearance of a scar that is wide and flexible can only be narrowed by total excision of the scar. Because the scar has a vertical orientation in the forehead, it runs perpendicular to its relaxed skin tension lines. This means that if a straight line closure is done after the scar’s excision, there will be a tendency for it to widen again. (although it may end up as wide as it is now) Changing the closure pattern to an irregular or broken line closure will redistribute the tension on the scar so that it will be more likely to stay as narrow as possible (less than 1mm) Also an irregular non-straight line is better camouflaged as it is harder for the eye to follow a broken line as opposed to a straight one. This type of scar revision is the best approach based on your scar’s description.
Dr. Barry Eppley