Hello,
I need advice and am desperate. 10 months ago, I was involved in an accident where a board smacked me in the forehead, creating a deep and jagged laceration all the way to my skull. I'm pretty sure I lost muscle/tissue. I had it repaired in the ER by a plastic surgeon. The scar that was left was very disfiguring. It was wide and depressed and very uneven. I had a scar revision surgery (a plastic surgeon cut out the scar and restitched it) 6months after the accident. It's been 4 months since then and the new scar has healed badly. It's still wide and depressed and extremely obvious in almost all lighting. Of course it looks the worst in overhead lighting and daylight. I'd say the scar revision maybe improved the scar by only 15%. Before this accident, my skin was perfect. I never worried about it and really took my good skin for granted. Now, I can't show my forehead in public. It has significantly reduced my quality of life and I feel like I will suffer until the day I die if I don't get this resolved.
The plastic surgeon who did the scar revision basically cut me loose and told me there was nothing else he could do. So now I'm consulting with other plastic surgeons and dermatologists. The problem is, everyone is telling me something different. I've gotten all kinds of suggestions, from another scar revision, microneedling, fillers, fat transfer, and subcision. Some say microneedling and subcision will cause more scarring, others say it will help. Some say no more cutting. I don't know what to do. I fear the reason why everyone tells me something different is because there is no cure for scarring and these treatments are offered by a host of opportunists.trying to make money ondesperate people.
I'm very scared to do another surgery because the first one failed so miserably. But I can't live with my face like this. I think I'm going to try a temporary dermal filler to start with. One plastic surgeon told me only to expect 10% improvement with a filler, while another one told me I'd be quite pleased. This is why I'm so confused and distraught.
I don't know what to do. I've been freaking out for the past 10 months of my life with severe anxiety and depression. I've read stories of people spending thousands of dollars on all kind of treatments and not getting any improvement. I'm really going crazy over this thing. Please, if any of you have some advice on treatments that have worked for your scars, please help.
I can totally relate to this. I've had failed scar excisions in the past and it's been an expensive process of trial and error for sure. I had a deep linear scar on my left cheek which was the result of a botched acne scar excision. It was long, linear, and depressed. Honestly the only things that have given me any improvement is fillers and resurfacing (specifically dermabrasion). Dermabrasion is very very aggressive and somewhat risky, but it does work for specific scars. For me, the fillers helped to raise the depression to the level of normal skin, and the dermabrasion is helpful for leveling raised areas and blending the scar edges. This approach is imperfect, but has yielded me the best results.
If you posted a picture, it would be easier to advise.
I'm sorry you're going though this. I can also relate to your experience. 
A photo of your scar would definitely help us give you better suggestions. Have you already posted it on RealSelf? You could upload it there with a question and link us to it plus get opinions from doctors. If you do require another revision if dermabrasion/resurfacing is performed within a critical window of 8-12 weeks afterwards it can significantly improve the outcome and help blend. I've also heard that if botox is used in the area prior to the revision it can help the scar stretch out less from tension. Maybe look into that? Also, keeping the scar taped for at least a month afterwards to help it not pull apart. You could follow that with maintenance home dermastamping (microneedling), chemical peels, retinoids to further help blend. Subcision/fillers if it needs to be raised. Depending where the scar is located specifically fillers in the forehead can be risky due to blood vessels that they can potentially block leading to serious consequences so you would need to see someone very experienced to make sure it's not a risk area for fillers. It can take a long time to reach the best possible outcome and scars look so much worse early on and after treatments. It's possible you could achieve an end result that can be hidden well with a little makeup. It will take time but I hope it gets easier.
"Scarabrasion" search on RealSelf:
[Link removed]
https://www.realself.com/question/united-kingdom-gb-railroad-marks#2522360
https://www.realself.com/question/forehead-scar-minimizationwhat-treatment
https://www.realself.com/question/united-kingdom-gb-my-forehead-scar-and-its-stitch-marks
https://www.realself.com/question/philadelphia-pa-i-long-scar-forehead-door-month-wanna-remove-hide
I've been searching realself nonstop since this nightmare began. I don't really trust most of the doctors that respond to scar questions, to be honest. But here is one of my postings, so you can see my scar.
Tried the botox thing after the revision and it didn't help. My surgeon did not suggest dermabrasion 8-12 weeksafter the revision.
I talked to Dr. Novick on the phone. He acted like he could pop up a deep scar with just one subcision and get almost 100% improvement. I don't trust him. There is nothing on the internet about him except a bad review on realself for someone that spent thousands of dollars on subcision/microneedling with zero results.
Interesting, I didn't get that impression but I'm not a patient of his and am just going off of his contributions to RealSelf so who knows. I noticed he seems to call out a lot of other doctors' BS and tell it like it is without selling hype. Dr. Davin Lim gives great advice that I think a lot of members here would agree with. I don't think one subcision could accomplish 100% improvement perhaps he meant subcision with the addition of filler to lift it. The research does indicate that those modalities can be effective over multiple treatments (for acne scars):
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3996784/
http://www.owndoc.com/pdf/therapy-in-treatment-of-atrophic-acne-scars.pdf
http://file.scirp.org/Html/9-1050288_57165.htm
I do like his scarabrasion within the critical window explanations and completely agree with him on that one. A lot of people here do home microneedling either with a dermastamp or derminator from owndoc. Microneedling done professionally with the Infini machine is expensive but maybe it would be less on just one area. I think you got many different answers because often it takes multiple modalities to achieve the best possible results - which can never be a complete cure butcamouflaged and blended to the extent possible (hopefully improved enough that you can accept it,live your life and hide what is leftreally, really well with a bit ofmakeup).
Thanks. This scar has already cost me thousands of dollars. Thousands. Both on treatment that hasn't worked and psychiatric therapy because of the emotional pain that I am suffering from. I had such a fabulous life before this. I was always active, social, great career, loved outdoor activities, the beach and the sun. Now I never leave my house. I'm basically waiting to die. My life is practically over at 33.
10 hours ago, blahblah82 said:I can totally relate to this. I've had failed scar excisions in the past and it's been an expensive process of trial and error for sure. I had a deep linear scar on my left cheek which was the result of a botched acne scar excision. It was long, linear, and depressed. Honestly the only things that have given me any improvement is fillers and resurfacing (specifically dermabrasion). Dermabrasion is very very aggressive and somewhat risky, but it does work for specific scars. For me, the fillers helped to raise the depression to the level of normal skin, and the dermabrasion is helpful for leveling raised areas and blending the scar edges. This approach is imperfect, but has yielded me the best results.
If you posted a picture, it would be easier to advise.
How much improvement did the dermabrasion/filler give? Did you have dermabrasion after the depression was resolved with the filler? How often do you have to get fillers? Is your scar white now? Mine has a very noticeable white line, surrounded by layers of depressed scar tissue, making it look very uneven, wide, and atrophic. It looks worse when I raise my eyebrow. It feels like the tissue is so soft and dead underneath the whole area surrounding the scar. But oddly enough this all is on top of a large bump that is much wider than the scar and this is visible in pictures. One surgeon told me the forehead is an extremely difficult spot for scarring, and I think he's right. It's such a prominent, flat place on the face with very little laxity.
All I can say is it gets a little easier with time. Hopefully others here will have better advice! Counselling is good. I'm not sure if I'm allowed to mention it here but since you're over 25... I find medical cannabis (high CBD, low THC strains so no/very little high) helpful with coping during times the depression and anxiety is unbearable. Sometimes you just need something to help get through the toughest times until you can continuemaking progress and adjusting the plan and your outlook. Keep talking to a counsellor and hopefully you can findadvice on the scarfrom a professional you can trust.
Edit: maybe I shouldn't have mentioned it but just in case this postsgets reviewed -I'm not promoting illegal behaviour rather assessment from a doctor to decide ifthe prescription of medical cannabis for anxiety and depression would be appropriate.
I took an antidepressant in the past and it really had some unpleasantside effects - reallybad experience for me.
I was also expecting a huge, hideous scar. I know it bothers you and that's what matters but I think there is a lot of hope with the multiple treatments available. Take a look at how some of these scars are hidden with time (often resurfacing is recommended after surgery). It could be much, much worse.
1 hour ago, arte90 said:I was expecting some huge ugly scar extending over your whole forehead, but really, it is not so bad. If you let this scar ruin your life than i am seriously wondering what that great before life was based on.
It's very visible and can't be covered with makeup. It looks like a chunk is missing out of my forehead. I bet you wouldn't want it on your face.
2 hours ago, Ommmmmm said:All I can say is it gets a little easier with time. Hopefully others here will have better advice! Counselling is good. I'm not sure if I'm allowed to mention it here but since you're over 25... I find medical cannabis (high CBD, low THC strains so no/very little high) helpful with coping during times the depression and anxiety is unbearable. Sometimes you just need something to help get through the toughest times until you can continuemaking progress and adjusting the plan and your outlook. Keep talking to a counsellor and hopefully you can findadvice on the scarfrom a professional you can trust.
Edit: maybe I shouldn't have mentioned it but just in case this postsgets reviewed -I'm not promoting illegal behaviour rather assessment from a doctor to decide ifthe prescription of medical cannabis for anxiety and depression would be appropriate.
I took an antidepressant in the past and it really had some unpleasantside effects - reallybad experience for me.
Yeah I tried antidepressants and they were awful. I used to deal with stress/anxiety through exercise. But I can't pull my hair back in public to go to the gym. That's how bad this is affecting me.
To preface my comment, I understand you're distressed by this, but I was also expecting something much more disfiguring. I'm not dismissing your feelings, just being objective. I think this is very fixable, and I'm surprised no doctor has been able to help you. Honestly I think some filler can give you quite a bit of improvement. My scar that I had from a botched scar revision is 10 times worst, and it was on my cheek. I'm also a guy, so there was literally no option to disguise it. I understand how distressing it is.
I think you could give a long lasting filler like Voluma a try.
On February 15, 2016 at 3:29 AM, blahblah82 said:To preface my comment, I understand you're distressed by this, but I was also expecting something much more disfiguring. I'm not dismissing your feelings, just being objective. I think this is very fixable, and I'm surprised no doctor has been able to help you. Honestly I think some filler can give you quite a bit of improvement. My scar that I had from a botched scar revision is 10 times worst, and it was on my cheek. I'm also a guy, so there was literally no option to disguise it. I understand how distressing it is.
I think you could give a long lasting filler like Voluma a try.
I just spent a week in LA, consulting with the cities top plastic surgeons. I even went to see the famous David Rahimi. Guess what? Everyone told me something different. Some said another scar revision surgery should make it totally flat and barely noticeable. Some said a filler might help. Some said learn to live with it and there was nothing they could do, that my last surgeon did a good job. Some said microneedling or lasers will make it almost disappear. One even told me that the plastic surgery industry is full of "used car salesman" and they will be quick to take advantage. This is one of the ones who claimed my surgeon did a good job, that I needed to accept it as a part of me, and then tried to sell me $1200 of 1 microneedling session with prp.
Im so confused and depressed. All of this makes me think that my scar can't be improved that much. Ive spent thousands of dollars already because of this nightmare. I've almost lost all hope.
Let me guess, was it Dr.Emer? He wrote something similar on your realself post. Why don't you start off with fillers first. If it succeeds, then you know that a permanent filler can be used in the future. If you don't like it, it will wear off. It certainly won't leave you worse off.
No I didn't go see him. I think that guy is a scam artist for sure.
i am going to ty a filler. But I don't know what to do if that fails.
@blahblah82what exactly did co2 resurfacing do for your scars? Did it help at all?
Personally, I don't think the co2 laser did much for my particular situation. I did Mixto once for the cheeks and it wasn't enough to make a proper evaluation. I'm not sure if more would have made a difference. For situations like yours, the advice you've gotten is pretty much expected. You can do another scar revision, then resurfacing. Or you could fill it to raise it up, then resurface to blend the texture. For you, I would say go with laser because dermbrasion is aggressive and frankly it sounds like you are already distressed enough. I think the recovery will be too much for you.
I think dermpen and PRP is all hype. Have yet to see any real science behind it.
I'm not that keen on Dr. Emer either because it seems like is more interested in marketing himself aggressively. He just goes to all the acne scar questions on Realself and posts the same cut and paste comment. Not helpful.
Curious, what did Dr. Rahimi advise?
3 hours ago, blahblah82 said:Personally, I don't think the co2 laser did much for my particular situation. I did Mixto once for the cheeks and it wasn't enough to make a proper evaluation. I'm not sure if more would have made a difference. For situations like yours, the advice you've gotten is pretty much expected. You can do another scar revision, then resurfacing. Or you could fill it to raise it up, then resurface to blend the texture. For you, I would say go with laser because dermbrasion is aggressive and frankly it sounds like you are already distressed enough. I think the recovery will be too much for you.
I think dermpen and PRP is all hype. Have yet to see any real science behind it.
I'm not that keen on Dr. Emer either because it seems like is more interested in marketing himself aggressively. He just goes to all the acne scar questions on Realself and posts the same cut and paste comment. Not helpful.
Curious, what did Dr. Rahimi advise?
Rahimi wants to fill it and then Mixto co2 it 3 times. He says I'll be very pleased with the result and that it will improve the scar significantly. To be honest, I'm not sure if I buy it. I called around other derms that have high ratings on yelp and they do not even treat scars. Then I called derms/plastic surgeons who carry the Mixto laser (according to mixto's website) and they dont even use it to treat scars. I think it's only used for fine lines and wrinkles. After my consult, I called his office back to ask a few questions. Initially, the front office lady told me he was in surgery. Then when I started asking more detailed questions, she asked for my name, put me on hold, and then dr. Rahimi (who was supposedly in surgery) got on the phone. It seemed very shady. Plus I saw someone's review on here how he spent over 10k on Rahimi's treatments with little to no improvement.
I'm terrified to do another scar revision. I got such a minimal improvement the first time, I just don't see how it would work the second time around. I think most good plastic surgeons don't want to touch a revision on a revision. And that was a lot of their responses. And I lost tissue in the accident, and I need something to fill it up. So I doubt doing the same thing (cutting and restitching) twice will work. A few of the most inexperienced surgeons claimed that my doctor who did the revision didn't do it right. Otherwise, you would barely be able to see the scar. But I did pick a highly reputable surgeon to do the revision. So I'm wondering if the inexperienced surgeons are the desperate opportunists.
Ive also been been told that this scar is much more difficult than an acne scar because it was cut to the bone and there is such a wide area of scar tissue surrounding the incision line. It was caused by blunt force trauma, and it was a star shaped jagged laceration with avulsion. I think the skin had to be stretched pretty far to close the wound. Plus the forehead is a very difficult spot due to the powerful muscles creating tension and forces that will stretch out a scar. People on this forum can't even get resolution with tiny acne scars!
So you can clearly see why I've almost lost all hope!
Do you all believe this study? Keep in mind it's from India