Your Questions
Your Questions
Q: Dr. Eppley, I am interested in a facial scar revision. I have a long grooved scar on my left cheek from a two layer Moh’s operation performed three years ago. I have had several consultations from Plastic Surgeons and now am confused. The plastic surgeons said the original doctor did not evert the edges during closure therefore this is why it looks like it does now. The last plastic surgeon I consulted stated he would place deep sutures and not evert and do zero top stitching, placing just a fine stitch running over and over and than taken out in a week to prevent stitch marks. When I asked if he would evert the skin edges he stated no. Is not eversion the only way to give the best possible outcome with a atrophic scar apart from tension on the inner layers? How do you do it .. The first, Vertical mattress no dissolvable sutures and evert….the next zero eversion and deep sutures. I though eversion was the way to go? Thank you for your time and consideration.
A: When it comes to facial scar revision the various techniques can be confusing. One has to look at the original problem, understand it and then devise a strategy which will improve the outcome. You have classic inverted scar, not because the right wound closure technique was not done, but because this was a wound closed over an area of tissue excision under some degree of tension. That combination is doomed to result in a wider inverted scar no matter how it was closed. Skin under tension closed over an area of deeper tissue deficiency is bound to sink in as it heals over time.
Your scar revision now is different. The wound edges will not be under such tension and there be no deeper area of tissue deficiency since nothing is being removed. Therefore, release of the skin edges and the deeper tissues with reapproximation of tissue layers will solve the inversion issues. There really is not need to do specific skin edge eversion. Providing deeper tissue support or buildup is the key. How the skin is closed is really irrelevant.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I have a facial scar is approximately three years old completely severing lip and chin tissues. An excellent alignment repair was done at the time. But over time the chin repair changed from a raised scar to an indention. What type of scar revision procedure would be used to correct it? Will this be a permanent correction?
A: Many facial laceration repairs look great early, become raised secondarily and then eventually become wider depressed type scars over time. This is due to the different phases of healing that occur from early inflammation, intermediate collagen deposition to late effects of scar contracture and collagen/fat resorption.
Given its facial location in which it completely violates the relaxed skin tension lines of the skin, a geometric type scar revision is needed. It would be either a running W-plasty or another form of broken like type scar revision. When the scar limbs interdigitate there is less chance of recurrent widening or depression of the scar. Most facial scar revisions do end up better in the long run but it is a process that will also go through the similar phases of healing that the original injury did.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I reached out to you last year regarding a consult for reconstructive facial surgery following an ATV accident several years ago. Since I have had several reconstructions and am now looking to improve my overall appearance and have reached out to you because of your experience in both aesthetic and reconstructive plastic surgery. Your name was also mentioned in a report by Advance Medical as an expert in this area.
At the time, you had requested a CT scan of the face, which I did not have–but now have one. I have attached photos, 3D reconstructed CT scan, and a brief medical history for your review. The goals of surgery are:
– Improve symmetry of the face, especially involving the eye. This includes the buldging of the eye ball itself, and position of the lid. I fully realize that a full restoration of symmetry is not possible and that surgery on the opposite eye may be necessary to get the most aesthetically pleasing result.
– Reduce the appearance of the port wine stain on the left side of face, near the eye
– Reduce the appearance of the scar on left cheek
– Improve overall appearance, ie. what procedures could be done in combination to ENHANCE overall appearance. Would a strong chin/jaw divert attention from eyes? Would other facial implants help? Would removing the nose bump? (This is why I value your experience in aesthetic plastic surgery)
I know you are very busy and I appreciate you taking a preliminary look at this case for consult.
A: Thank you for sending your pictures and 3D CT scans. What they show is that despite an excellent anatomic reduction of the fractured zygomatico-orbital bones (and an infraorbital-malar implant) your face is not normalied. The problem now, and is a quite common one after facial trauma and multiple reconstructive surgeries, is that the original injured tissues have become ‘skeletonized’. There has been loss of subcutaneous fat with scar tissue that has caused lower eyelid scar contraction as well as the lower facial scar prominence. I think that the left eye does not really bulge but that the lower eyelid is vertically short and contracted, exposing more sclera in that eye.
From a reconstructive standpoint focusing on the original injured tissues, I would recommend the following:
- Lower Eyelid Reconstruction with Dermal-fat Graft and Lateral Canthoplasty (your prior canthopexy was insufficient)
- Left Geometric Facial Scar Revision (your prior laser resurfacing probably made little difference)
- Injection Fat Grafting to Left Cheek and Infraorbital areas (the tissues don’t need suspending, they need more volume.
From an aesthetic standpoint, I would need more pictures for better assessment for both rhinoplasty and jawline enhancement.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I was left with a depressed facial scar with dog ears as a result of multiple cyst removals on the left side of my face along the smile line by my nose. I have been told by plastic surgeons that my scar condition can be improved with fat injections for the loss of volume and surgery which will expand the current scar even more to address the dog ears. I found your article on the internet on the aesthetic refinement of the dog ear correction very encouraging. I am hopeful that it would work on her scar. Please advise.
A: Thank you for sending your facial scar pictures. The depressed scar and dog ears are very evident as you have described. Your facial scar revision would initially consist of elevating the depressed scar can be done with either fat injections or an actual dermal-fat graft. Given the need to harvest dermal-fat grafts with a resultant scar, even though they take better, fat injections would be the preferred technique given that its harvest and injection can be done in a relatively scarless fashion. As for the dog ears, the classic teaching is that the scar must be extended to excise them. And given how they look for a small amount of scar length increase that is not necessarily a terrible idea and may be the best solution. An alternative approach is to defat them with limited excision and see how that turns out.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I had done a facial scar revision on my jaw bone at mandibular line by w-plasty method because I have the problem in past my scar get created to hypertrophic scar after some month so i choose w-plasty option. Now it is 7 month completed kindly find the attach photo of my scar. Can I do some thing else to lighten the scar and match with my surrounding skin color. Currently I am using silicone Cica Care sheet at night and silicone gel in daytime with sunscreen of SPF 30. I want to reduce the redness of the scar. Please help me out.
A: Unfortunately while facial scar revision by w-plasty was a good treatment choice, you still have scar widening and a mild degree of scar hypertrophy. While it is possible that more healing time alone may help the scar redness, there is little that any type of topical scar therapy is going to improve over what you have now. Given your propensity for scar hypertrophy and your skin type, the only hope of any real improvement in the appearance of the scar is going to be through a repeat scar revision combined with 5FU injection therapy. Steroid injections with a scar revision in your skin type is too risky for skin pigmentation changes.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I am interested in a facial scar revision. My facial scar is three years old and is the result of a sharp tool attack. It was thinner after the attack but has grown considerably larger with time. It also appears more indented now. What are my scar revision options to make it less noticeable? I have attached several pictures which shows the scar as it cross the cheek and goes below my eye.
A: You have a very classic scar pattern that occurs when a long scar horizontally crosses the cheek area. Since it runs perpendicular to the relaxed skin tension lines (RSTL) of the face in that area, it is very prone to widening over time no matter how well closed it was initially. This creates scar widening and an indentation along its course as the weight of the facial tissue pulls down on it over time. Your long facial scar can be improved but its appearance can not be completely eliminated. It needs to be excised along its length and then put back together in a broken line closure pattern. Such interdigitations prevent the recurrent scar widening that you now have. While in some cases of facial scar revision it would be followed months later by light laser resurfacing or dermabrasion, your darker skin pigmentation would preclude that final touch-up after your scar revision.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I am interested in facial scar revision for my son. My son will be five years old this year. About 2 years ago, he hit his head on an end table and got a cut above his eye. We took him to the local emergency room and they glued it back together. He has a terrible scar now. About a year ago, I took him to a few local plastic surgeons and they all said there was anything they could do for him. I am desperate to find some way of improving how this looks. I am attaching a photo for reference. Is there anything that can be done to improve how the scar looks? I realize there is no way of eliminating the scar, but I hope there is at least some ways of making it not as noticeable. I was very impressed by the examples of your work shown on your website.
A: When considering facial scar revision, the most important question is what are the physical characteristics of the scar and how mature is the scar. Scar revision is most effective in scars that have altered surface contours (wide, depressed, raised) or are in poor orientation to the relaxed skin tension lines of the face. Your son’s scar is very wide and slightly depressed above his eyebrow. I would certainly not agree that there is no improvement that is possible for it. The scar can be excised and closed in a fine narrow line with a smoother skin surface. While this will not eliminate or erase the scar, some definite improvement can be obtained. The reluctance to offer scar revision in your son may have been because he is so young. But a young age does not preclude scar revision surgery nor foretell of a poor outcome should it be done.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I am seeking facial scar revision. I have a straight facial scar from the corner of my ear to the corner of my mouth on the left side of my face. It was from a knife attack. It happened when I was 16. I am now almost 47 years old. Could you please review my face?= and tell me if I am a good candidate for scar revision?
A: In looking at your pictures, the scar width is not terribly wide but it is a straight line from the mouth to the ear. As would be expected from an injury now thirty years old, the scar is quite mature. There is probably merit to excising the scar and placing some geometric changes along the line that breaks up its linearity, particularly in the locations of the smile lines. While there is no way to ever completely remove the scar, it is possible to make it less obvious than it is right now.
The key decision for your scar revision, however, is unique because of how old the scar is and your age. You have lived with it for so long it is an accepted part of your appearance. (I didn’t say you liked it but it has been with you for most of your life) Whether the time necessary for healing and having the scar mature again to get to whatever improvement can be obtained is a big sacrifice at your point in life. Whether the amount of improvement obtained is worthy of that sacrifice is very hard to determine beforehand.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I have a depressed cheek scar above my nasolabial fold from a previous skin cancer removal using a Moh’s technique. If you inject fat do you utilize the Coleman technique with micro droplets to ensure the tissue becomes a graft and not just a temporary filler? Anyhow, I do not like the dynamic feature when I move the facial muscle as well as when the sight catches the groove of the scar. I have attached some pictures showing the scar. Thank you for your time.
A: Thank you for sending your pictures. I did not realize how young you were given that you have had Moh’s. It is actually a reasonable result in a difficult aesthetic area. The only modification I would make to my previous statement is that I would perform a geometric scar revision at the same time as microdroplet fat injections underneath. Even though the scar is well placed and has about as much narrowness as could be hoped for, there is always going to be a ‘groove effect’. That is just an unavoidable phenomenon in linear scar in that area. The scar line may need to changed from a pure straight line to get a better scar effect. Options include either fat injections with concurrent laser resurfacing (#1) or fat injections with a concurrent geometric broken line scar revision. (GBLSR) The conservative approach would be # 1 as GBLSR can always be done later based on the scar outcome. The more aggressive approach would be #2.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I have a facial scar below my left cheek that I want revised by a geometric broken closure. One question I have is that I had Silikon 1000 injected under the scar to try and raise it several years ago. The material has migrated around the scar making the scar look even more indented as the surrounded tissue is raised. So I know the scar I have is around 2.2cm but I’m not sure how wide it is including the surrounding skin. Would you be able to remove the Silikon 1000 filler or at least the raised skin around the scar? If so could you still do geometric broken line excision or would you have to do a straight line scar. I REALLY want to get rid of this Silikon 1000 but not if it leaves me looking like one side of my face is way thinner or not symmetrical to the other side. What would be your advice with this? Warm regards.
A: Once silicone oil droplets are in the tissues there is no way to get it out unless it is part of the actual scar revision. I would treat the fact that there is silicone in the tissues as irrelevant. It would not change how I would do the scar revision or the amount of tissue removed. Trying to go beyond the actual scar borders in an effort to achieve the ancillary goal of silicone material excision is fraught with causing additional scar problems. It is best to treat the scar as if it was not there.
Dr. Barry Eppley
Indianapolis,Indiana
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
Indianapolis,Indiana
Q: Dr. Eppley, I have got a knife scar on my face since I was 5 years old. It is about one and half inch long, is not very deep by any means. I can really see it from 3 feet away. However, it still bothers me sometimes. Is there a way to make it disappear? Thanks a lot.
A: Scar ‘disappearing’ is not likely in any scar. Its further reduction in appearance may be possible, but there is no such thing as scar elimination. The involved skin can never be made completely normal. Scars can be made more narrow, more smooth and have a more normal color, but they can never be completely eliminated or made to completely disappear. Whether any of these techniques or changes will be beneficial to your scar, I would have to see pictures of the scar to provide a more specific scar revision recommendation.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I am writing you because I had an scar revision and the post surgical treatment was wrong. Now I am desperate and want to know if there is any solution to my problem. I have attached pictures of my before and after surgery condition.
A: In looking at your before and after pictures, I fail to see what you have described as wrong treatment. Your initial scar pictures shows an extremely wide scar, up to 2 cms, that extends from the corner of your mouth down to your jaw angle/neck area. Your postoperative photo shows a much more narrow scar that is in the healing process. In my practice, I would have told you from the beginning that a good result from your type of scar revision would take at least 2 stages (surgeries) and 12 to 18 months to get the final result. You have a horrendously wide scar that runs completely perpendicular to the relaxed skin tension lines of your face. These combined eatures makes your scar revision extremely difficult. The first stage (surgery) would be to just get the scar much more narrow and I would expect some rebound widening afterwards. That appears to be where you are now. You need to let this first stage scar revision heal and then proceed to the second stage (surgery) where further narrowing will be possible and the introduction of some broken line/geometric scar revision techniques used for improved scar camouflage.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, four months ago I had two moles removed on my cheeks. The plastic surgeon removed them by circular excision to achieve a short scar. She didn’t mention the dreaded dog ear deformities that I have now been left with. I now have four white hardish protuding lumps at either end of where my moles were. So I have no moles but four lumps instead. Was this a bad method of mole removal? The plastic surgeon is still hoping that they will flatten in time but my cheeks are quite fat and I am seeing no improvement or flattening out so far. How long shall I wait to hope that they will dissapear or do you think four months without any improvement means that they won’t. Would much appreciate your advice as I really don’t know what to do for the best result. I have very little in the way of scar where the mole was but if I now have to have the lumps excised what can I expect in the way of scarring?
A: Removing the smallest amount of normal skin when removing a skin lesion, particularly on the face, is a desired approach. In many ways, you have had a ‘punch excision’ but without using that specific instrument. The trade-off for a circular excision is that there may residual skin (dog ears) as you now have. After four months, most likely what you see if what you will have. Improvement will only come from a scar revision (elliptical excision) now. While there are scar concerns, your recent experience shows that you seem to scar fairly well in this facial area. You will have to decide whether a flatter scar or these bumps are better aesthetically. That is as much as I can say without seeing pictures of these areas.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I am wanting to get rid of a scar on my forehead. Here is my picture and I’m hoping that this is something that you would be able to erase. I hate this scar on my face. I am getting married in three months and I need this scar off so I can look my best for my wedding and pictures. Please let me know how soon I can get in and how many sessions it will take to get rid of it.
A: The scar on your forehead that runs vertically down through your eyebrow and into the top of your nose can definitely be improved. But one reality that needs to be faced about scar treatments is that such outcomes as ‘being erased’, ‘gotten rid of’ and ‘removed’ are not possible. Scars can be improved but, in general, there is no such result as being removed like it was never there. The realistic result of scar revision efforts is to lessen its appearance. Some remnant of the scar will always be there. The features of your scar would be best treated by surgical scar revision and an irregular closure pattern. Because the scar will be initially red and will take time to mature and lose its color, having scar revision done three months before your wedding is the minimum amount of time you should allow.
Dr. Eppley
Indianapolis, Indiana
Q: I had a bad car accident three years ago which left me with many scars. Most of them are on my arms and back and and don’t bother me much because I can’t see some of them and I am tan enough so that they don’t show. However, the one on my face is awful. It isn’t a flat scar, but more of a jagged edge, indented spot on my face. It looks like a large unnatural dimple when I smile along my jawline. Can this scar be removed? I am planning a wedding for next year and would love scar free photos!
A: In looking at a picture of the scar, it can be seen to be a wide and indented scar along the jawline. Scars that cross the jawline rarely do well because of going over a transition zone between two facial planes and being exposed to tension. This will cause the scar to become wide. I think scar revision can make a big improvement but it is important to realize two important realities about scar revision. First, there is no such thing as scar removal or being scar free. There is improvements that can be made to an existing scar and it is all about how inconspicuous it can be made. But you will always have some permanent scar. Secondly, scar revisions take time to mature meaning that it will be red for months afterwards before the color blends in better to the surrounding skin.With a wedding coming up sometime next year, the sooner you undergo the scar revision the better.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I’m currently seeking to get rid of a facial scar from trauma (long, hypotrophic, discolored, widened vertical cut on the cheek about 3cm long running perpendicular to the RSTL and a “v” shaped hypertrophic, discolored scar on the jaw line below) that’s over a year old now. Treatment thus far has been with silicone tape on and off. I’m not sure if w-plasty, z-plasty or laser resurfacing would be the best option? I’m not sure if you specialize in these types of cases. Any suggestions/advice/thoughts would be greatly appreciated. I was searching online and came across your website. Thank you.
A: There are two important features of your right vertically-oriented facial scars; they are both wide and they are actually parallel (not perpendicular) to the RSTL in that area of your face. Because the scars are wide, they are not improveable by any form of laser or skin resurfacing. Wide and depressed scars by definition need to excised and reclosed to be made more narrow. The only question is whether they should be closed in a straight vertical line or in an irregular pattern like a running w-plasty. The irregular scar revision pattern is aesthetically preferable for better camouflage.
As a final note, the concept of getting rid of a facial scar is not possible. The scar can be made less conspicuous but it can never be completely removed.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I have a scar in the middle of my eyebrows that has bad indents from stitches that look like a train track. Can scar revision fix these indents?
A: When referring to indents, it appears you are talking about the stitch marks which are often called ‘train tracks’ or ‘train-tracking’. These are the result of using sutures that are too big for the face, leaving sutures in too long, or a combination of both. What they are is the healed indentations from where the sutures went into the skin and the skin healed around them. While all sutures have the potential to develop these dots or indentations, large sutures leave little round white holes and sutures that have been left in way too long can have these hole which are indented.
These train track scar marks can be difficult to remove since they lie outide of the existing scar, making wide scar revision often not possible. This leaves the option of removing the track marks iindividually through small punch excisions. This may make it possible to improve the indented nature of theae marks but there will always be a small white scar from the original or new hole. I wowuld have to see a picture of how bad these marks to determine of there is any worthwhile treatment option.
Dr. Barry Eppley
Indianapolis Indiana
Q: Dr Eppley, I came across this page while doing research on scars. My 6 yr old daughter had a traumatic injury to her left cheek about three wks ago. A face laceration in the shape of an anchor, right in the front of her cheek. As her parent I was and still am very upset that this has happened to her. Not only for cosmetic reasons but I’m worried about her self esteem later on. I’m hoping it will heal better than I can imagine. Currently we have seen two plastic surgeons and they had me in tears with their negativity. I was wondering if you could look at her picture and have some advice. When or if the time comes, we plan on doing what we can for her. Thank you for your time and I hope to hear from you with your expertise.
A: I obviously would have to see pictures of your daughter’s scars before rendering an opinion. But having taken care of many hundreds of facial lacerations to children over the years, what often looks very discouraging and grim early on can go on to heal, either just by time or plastic surgery scar revision, to look much better than one would have ever thought. She will have a residual scar for sure but the goal is to see how minimal it can become. The cheek area can be a difficult area for scars because it is a bony prominence and is under some tension. But the healing potential of young growing tissues is significant so there is no reason to be discouraged no matter how it looks right now.
Dr. Barry Eppley
Indianapolis Indiana
Q: My daughter was in a MVA in October 2010. She has an Y-shaped scar on her forehead and 2 smaller scars on her left cheek and left ear. We have consulted with a pediatric plastic surgeon, but would like a second opinion on how soon can scar revision begin and the best treatment for the best long-term outcome.
A: Scars on a face are always very emotionally disturbing. Those concerns are only magnified exponentially when those scars are now on your own child’s face. Many parents, and teenagers, are very interested to get started on a scar revision/treatment program as soon as possible for very understandable reasons.
When and whether scar revision is of benefit is going to vary based on multiple factors including the type of scar, its location and what skin texture issues it has. The classic teaching in plastic surgery is that scar revision should wait at least one year after the injury. While this can be true for some scars, it certainly is not true for all of them. The rule of thumb that I use is…will time be of benefit or not to the scar’s visibility problems. If a scar is thin and red, time will eventually make the redness disappear as the scar matures. One may want to try and hasten that up with some pulsed light therapies (IPL, BBL) and this is perfectly appropriate as it is harmless to the scar and quick and easy to do. If the scar edges are mismatched, wide, or uneven, these features will not be improved with time and earlier scar intervention is then justified.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Hello Dr. Eppley, I wanted to that you for such a fast reply. I have looked through your facial scar revision work you have done and believe you can do something for me. I got a scar along my left lip to the side of my nose over one year ago. I have a few scars since I was a kid but I have gotten used to them. This new scar is by far the ugliest and biggest scar I have gotten. I don’t see anything but the scar when I look in the mirror and it bothers me alot. I understand that half of it is mental but I still would like to keep my face as close to perfect as possible. I already went and saw a doctor who charged me $150 for consultation and really couldn’t help me. I have used Bio Oil, and Mederma regularly and not sure if it’s a good thing to do. My scar is the same color as the rest of my skin but the only problem is its indented. All you see is a deep line which makes my appearance stand out. I went to a place where I paid lots of money and got some kind of liquid that they shot under the skin. It is a filler that only lasts 8 to 12 months. Like I said the scar being indented is the only problem. Whenever I stretch my mouth you can’t see the scar at all, and that’s all I need is to stretch my skin somehow so it stays that way. The filler they have shot in to my scar came in size .8, I have used .2 the first time and .2 the next time. I don’t know if any of this information helps but using that filler didn’t help much. Please tell me if using too much of Bio Oil or Mederma is bad for it. What are you suggestions?
A: Thank you for sending your history and the pictures. You have a mature scar that is obvious, not only by its location, but by its indentation along its entire vertical length. The indentation of the scar, fortunately, is in a favorable orientation being vertical on the side of the lip. That is advantageous for a favorable scar revision outcome.
As you have correctly pointed out, improvement in the scar is only going to come from improving its indentation. There are two options for long-term/permanent improvement. The first is to surgically treat it by doing a formal scar revision, excising the depression from the scar and re-closing it so that it is even. That will require a ‘stepping back’, so to speak, as the scar will be read for a while before the color fades. The other approach is to place a thin dermal graft underneath to push the indentation upward. That avoids cutting out the entire scar and the required time for scar fading. Either option is better, in my opinion, than injectable fillers and any method of skin resurfacing. You may stop the topical treatments as they will have no effect on a mature scar and are not capable of raising up the indentation.
Dr. Barry Eppley
Indianapolis Indiana
