What Is The Best Method To Revise My Forehead Scar?

Q: Dear Dr. Eppley, I wanted to send you my pictures to review. I had a childhood scar which I had revised in 1995 and the result was this elongated revision which I have not been too happy with. It has been about 16 years since then and I was hoping to find out if can have anything done to make it less visible. I am currently 30 years old and of Asian decent. If you have few minutes, I would appreciate your input on a few of the questions as it will help me be more knowledgeable.

1. I realize that the scar revision is replacing one scar with a less visible one. Would you consider the revision for this vertical midline scar to be GBLC, serial W-plasty or a simple vertical excision?

2. I know there may be a bandage or silicone gel sheet after the procedure. Any idea of how long I need to wear one and the down time in general?

3. Following the revision, would there be any additional resurfacing required? If so, would you recommend dermabrasion? And any idea of total number of follow-ups required?

A: Thank you for sending your pictures and reviwing your scar history. Your forehead is a relatively flat wide scar that runs vertically right down the middle of your forehead. In answer to your questions:

  1. As this scar runs completely perpendicular to the relaxed skin tension lines of the forehead, which run horizontal, any successful scar revision should nto be a straight line. Some form of irregular pattern needs to be used. Given that the scar is absolutely vertical, I would use a running or serial w-plasty type of scar revision.
  2. I would apply just some glued brown tapes for a week after the procedure over the sutures. Thereafter, one would apply a light antibiotic ointmnent for an additional week and then change to a topical  scar gel. Scarguard is my preference.
  3. I suspect that some light laser resurfacing may be beneficial done once about 6 to 8 weeks after the procedure. That would depend on how the scar appears. Definitely not dermabrasion as that is too deep. With your Asian skin I would be very conservative with any type of scar treatments that use heat due to the risk of pigmentation changes.

Dr. Barry Eppley

Indianapolis Indiana