Sunken scars

Healing ability after surgery is a somehow unpredictable biological phenomenon with extreme variability between ethnicities, individuals, skin quality of different anatomical areas, features of the surgical technique and multiple genetical and mechanical factors; there are well known factors leading to a unfavorable aesthetic outcomes, including but not limited to black skin, sebaceous or oily skin, certain areas like back, shoulders, chest, mandibular angle and earlobe, abdomen, etc, causes by mechanical stress and pull from the wound edges like hematoma, seroma, excessive postoperative swelling or inflammation, poor surgical planning, features inherent to the surgical technique, etc; notwithstanding some areas are prone to superb aesthetic quality of the scars, like the scalp, face, eyelids, ears, lips, nose, intraoral mucosa, areolas, etc.

Scars might not be leveled with the surrounding skin contour due to several causes like fat necrosis, skin necrosis, in depth adhesions, muscular attachments, poor suture technique, etc.

Treatment is initially expectant, since most cases evolve favorably and spontaneously; should the evolution be unfavorable late and scheduled surgical revision could be indicated.