What Type Of Forehead Scar Revision Do I Need?
Q: Dr. Eppley, I have a pretty big scar which runs down the middle of my forehead. It is from an accident I was in last October. It was cut down to the skull and they did plastic surgery but my doctor said its all healed now. I want it to blend in more and not look so scary. What type of scar revision would help me the most?
A: As your scar is now nine months old, it is likely close to maturity. This is confirmed by your doctor saying that it is ‘all healed now’. In looking at your pictures, your scar could be improved through further manipulations. It is not tremendously wide but it is visually obvious because it is a vertical scar in the forehead where the relaxed skin tension lines (RSTL) run horizontal, completely perpendicular to your scar’s orientation. I think you would benefit by a two-staged scar revision approach. A first-stage running w-plasty scar revision done under local anesthesia in the office. This would help change the straight line vertical scar appearance to a more of a broken line closure. That would achieve two things. First it will help redistribute the tension better by the interdigitation of the wound edges so it will likely end up as a more narrow scar. Secondly, an irregular line is a better camouflage when the scar runs adversely to the RSTL of the forehead. If needed, a second-stage fractional laser resurfacing of the scar several months later for optimal blending into the surrounding skin.
Dr. Barry Eppley