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Plastic Surgery/Cyst removal scar

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Question
Hello.  I had a sebaceous cyst removed from my face many years ago.  It was removed by a highly regarded PS.  It left a 3/4" indented scar.  There's no dimple from the cyst but the whole surgical line is indented and very noticeable in the right light conditions.  I've consulted a few other PS's and they said a scar revision could make it worse so I never bothered.  I did try a filler but it didn't work.  I don't think my PS used buried sutures and everyone seems to recommend buried sutures.  Is this why the scar is indented?  If you have any solutions I could try to improve this scar, I would greatly appreciate it.

Answer
from Dr. Alan Engler
www.bodysculpture.com

Hi Rick,

It's difficult to make an assessment and treatment recommendations via this forum, and without a photo, but here's what I'd say in general:

It is not at all uncommon for surgical scars to be less cosmetically desirable than the patients would like, and you have to try to figure out why.  Sometimes, excising the scar and reapproximating it with layered sutures can provide an improvement in its appearance, although there are no guarantees that the scar correction will persist (sometimes the forces causing the unfavorable appearance - such as muscle pull - persist).

The indented appearance, however, may also be due to the size of the mass that was removed.  In general, the larger the mass, the greater the disruption of the surrounding soft tissue.  For long-standing masses the loss of subcutaneous tissue can be permanent.  If that's the cause of the indentation, then simply resuturing will not be likely to help, as the underlying defect persists.

It may or may not be a question of buried sutures but having someone see this in person is the best idea.

I hope that this helps and good luck,

Dr. Alan Engler
www.bodysculpture.com

Plastic Surgery

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Alan M. Engler, MD, FACS

Expertise

Dr. Engler has answered over 6400 questions on social media sites, including over 3500 on AllExperts alone. His expertise includes breast surgery (breast enlargement with implants, breast reduction, breast lifts), liposuction, eyelid surgery, tummy tucks, facelifts, lipomas, skin cancers, cysts, etc. Dr. Engler has been listed as one New York`s Top Doctors, and as "One of the World's Most Famous Aesthetic Surgeons" (Aesthetic Surgery, TASCHEN Books, Angelika Taschen, Editor). He is the author of 4 books, including "BodySculpture" (a best-selling plastic surgery book on breast surgery, liposuction and tummy tucks), "EyeScapes" (Plastic Surgery of the Eyelids), "Restylane," and "The Slim Book of Liposuction." Dr. Engler has two US Patents for surgical instruments that he's designed, and has appeared on numerous television shows, including The Tyra Banks Show, The Ricki Lake Show (four times), the Dr. Keith Ablow Show and Jerseylicious. Videos of his appearances are available on YouTube (search for "DR. ENGLER"), and his discussion of breast implants, also on YouTube is "How to Choose a Breast Implant." His website is www.bodysculpture.com. Follow Dr. Engler: @AlanEnglerMD

Experience

Dr. Alan Engler is a board-certified plastic surgeon in New York and the author of BodySculpture - Plastic Surgery of the Body for Men and Women (ISBN 0966382749) one of the top-selling plastic surgery books on amazon.com, barnesandnoble.com, as well as EyeScapes - Plastic Surgery of the Eyelids.

Education/Credentials
Dr. Engler graduated from Yale University (BA, Russian Studies) and the Columbia University College of Physicians and Surgeons (MD). He did his residency training in General Surgery and, after that, Plastic Surgery, at the Montefiore Medical Center in New York. He is on the faculty of the Albert Einstein College of Medicine in New York in the Departments of both Surgery (Plastic Surgery) and Medicine (Dermatology), and is a Special Lecturer in the Department of Dermatology at Columbia University in New York. He has admitting privileges at Beth Israel Medical Center and Montefiore Medical Center, both in New York.

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