Q. Involuntary frowning is delaying the healing of my scar revision surgery. Should I get Botox?

Answered by
Dr. Vikram Kumar R
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jun 05, 2017

Hi doctor,

My scar revision surgery is not healing well, and it seems worse than last week. Please see the attached picture. Involuntary frowning causes lines to run through the scar, can this be causing problems? Is it worth taping my forehead, so I cannot make frown lines? Is it worth getting a botox to stop frowning till I am healed? I am using a vitamin C and silicone scar cream to attempt better removal of hyperpigmentation. Is this a problem? I cannot tell if it is this or the creasing making it worse. I am starting to get very depressed about this scar revision. It was bad enough getting mugged and getting this wound. Now it is not healing even after a scar revision surgery. Thanks.

Dr. Vikram Kumar R

Cosmetology Hair Transplant Surgeon Plastic Surgery – Reconstructive And Cosmetic


Welcome to icliniq.com.

Thanks for the query. I have seen the attached picture (attachment removed to protect patient identity).

  • It looks like it is a very early stage following scar revision. It looks good right now. But, it will take time for the scar to get better.
  • The following might help:
  1. Daily massage with silicone ointment.
  2. Silicone sheet application at night.
  3. Low dose botox around the scar to prevent the scar from stretching due to facial muscles can also help.
  4. After few days, fractional CO2 laser resurfacing can also help.
  • Consult your specialist doctor, discuss with him or her, and start using the medicines after their consent. But most importantly, it takes time and being patient really helps.

For more information consult a plastic surgeon online --> https://www.icliniq.com/ask-a-doctor-online/plastic-surgeon

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Thank you doctor,

The images I uploaded show it getting worse due to the creasing. I have uploaded three new pictures, showing the post revision separation problem. So, you can see what I am trying to tell you. I am worried this creasing is impeding and making the repair get worse. And I will be stuck with a bad scar and weird 45 % crease line running through it for the rest of my life. The revision that I had done four months back went well surgically, but poor aftercare at the hospital caused it to separate slightly. I have the vitamin C and silicone cream, and I will massage it morning and afternoon. I have Scaraway silicone strips, which I will put on at night. Should I take some measures to stop the crease from running through the scar? I believe this is the most problematic part of my recovery. Currently, I am using a surgical tape to pull my forehead apart, so I cannot frown. Any final advice is welcome. Thank you.

Dr. Vikram Kumar R

Cosmetology Hair Transplant Surgeon Plastic Surgery – Reconstructive And Cosmetic


Welcome back to icliniq.com.

I saw the new images also (attachment removed to protect patient identity).

  • It is getting better. As days progress, it will become better, do not worry.
  • Botox will help to prevent the scar from stretching due to muscle action. But, get it done as soon as possible. Once botox action kicks in, you can get fractional resurfacing done.
  • Tapes do not help that much.

For further queries consult a plastic surgeon online --> https://www.icliniq.com/ask-a-doctor-online/plastic-surgeon

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