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Hello Acne.org forum I am Rene. I signed up though I have looked at this site for few months. I have a sunken scar on my forehead.

post-113582-1254382791_thumb.jpg

I forgot how got it, less than a year ago, probably due to some acne? I read several ways to treat sunken scars:

acid,

injecting collagen/fillers/etc,

dermabrasion,

laser resurfacing,

subcision,

punch excision.

???

I was just wondering if anyone here could please offer advice which is the best one? I don't think I want to inject anything into it or acid...maybe something more permanent?

I am half german half italian, I have darker skin than most and am afraid dermabrasion or and laser resurfacing might get hyper/hypo pigmentation? Also maybe these don't work. I read they only can lessen the appearance of sunken scars...mainly used for elevated scars?

So maybe subcision or punch excision? I don't know if these treat for different things, I heard subcision is less surgery/risk involved...true?

What about if I took accutane before ---maybe 9 month ago---, and want subcision or punch excision now? Is there any more risks involved??

Do dermatologists or plastic surgeons handle these procedures?? Which one would be better for which procedure??

Sorry for so many questions.

I appreciate anyones help, please!!!

Rene

post-113582-1254382791_thumb.jpg

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Due to the fact this is an isolated scar, is rather large and looks deep. I would say your best bet is to have the scar surgically revised (scar revision surgery). DO not let anyone talk you into laser filler etc. YOu will not have any improvement from any laser - they only slightly improve the most shallow scars. It looks to me as a filler would not improve this scar because it appears very bound down for a filler to be able to push it up - the filler would simply donought hole around the scar. (Even if you had subcision before the filler you would probably only see slight improvement)

Go to at least three different plastic surgeons that specialize in scar revision for consults before you pick one. I also recommend researching surgical scar revision techniques so you can ask the right questions. A good surgeon would properly undermine the scar and close the revision in layers. You may also want to ask about a w-plasty type closure.

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Due to the scar being on the forehead, fillers may not work without subcision. I definitely think you can see a 50% improvement with 1 round of subcision. After that you can get even more improvement with a filler such as Perlane or Restylane.

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thank your for helping me!!

Now I may choose between subcision and excision or scar revision surgery!

Is a "w-plasty" a separate procedure -- or part of a subcision/excision/revision surgery?

Also what do you guys think about subsicion/excision/scar revision when I have already taken accutane?? I have done it months ago near 9. Should I wait longer or maybe it is ok?

I am very grateful for your answers

Rene

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