Depressed Scar After an Injury or Old Surgery: When Fat Transfer Works and When Scar Revision Is Better
Written by Dr. Ashutosh A Shah, M.B.B.S., M.S., M.Ch., D.N.B., Board Certified Plastic Surgeon. Reg. no. [REG NO]. 22+ years in plastic and reconstructive surgery.
Medically reviewed by Dr. Ashutosh A Shah · Published 14 October 2026 · Last reviewed 14 October 2026
Fat transfer suits depressed, tethered scars where tissue volume is missing, such as old injury or surgical scars on the face, thigh or abdomen. Fat is taken by gentle liposuction, processed and injected under the scar, often with release of stuck bands. Wide or stretched scars usually do better with excision, and some need two sessions.
Can fat transfer fix a sunken scar? Often, if the scar is sunken because tissue under it is missing and the skin is stuck down. A fat injection in depressed scar tissue replaces lost volume and loosens the tethered skin. It is less useful when the problem is a wide, stretched scar on the surface. This page explains which depressed scars suit fat transfer, how it is done, how much fat survives, when cutting the scar out is better, and what recovery involves.
Which depressed scars respond well to fat transfer?
Scars that dip below the surrounding skin because of missing fat or soft tissue, especially when they are pulled down by bands underneath. Typical examples:
- Old injury scars on the face, thigh, leg or arm, where a blow or cut damaged the fat beneath.
- Surgical scars that sank or stuck to deeper layers, such as drain sites or old abdominal scars.
- Scars after infection or abscess drainage, where tissue was lost.
- Tight or tender scars, where softening is the aim as much as filling.
- Pitted scars on the body, where a pitted scar solution needs volume rather than a surface treatment.
The selection table sets out the main depressed scar treatment options by scar type. It is a guide for discussion, not a diagnosis.
| Scar type | Depth | Tethering | Best option | Expected sessions |
|---|---|---|---|---|
| Narrow, sunken scar after injury | Shallow to moderate | Mild | Fat transfer with subcision | 1, sometimes 2 |
| Deep pit with missing fat | Deep | Firm | Fat transfer with subcision | Usually 2 |
| Scar stuck down, little volume loss | Shallow | Firm | Subcision alone, or with a small fat graft | 1 |
| Wide or stretched scar | Any | Mild | Excision and careful closure | 1 operation |
| Large defect with poor skin or exposed deeper tissue | Deep | Firm | Local flap, sometimes followed by fat transfer | 1 or more operations |
What is the best treatment for a deep depressed scar from an injury?
Usually release of the stuck bands combined with fat transfer, often in two stages. If the scar is also wide or the skin over it is poor, excision or a flap may come first.
How is the scar released and filled in one sitting?
In three steps, usually in one session:
- Harvest: fat is taken through a small cut using gentle, low-pressure liposuction, usually from the abdomen or thigh. Our page on Liposuction used for fat harvest explains the technique.
- Processing: the fat is cleaned and concentrated so that only healthy fat cells are injected.
- Release and filling: a fine needle or blunt cannula cuts the fibrous bands holding the scar down, called subcision. The freed space is then filled with tiny threads of fat at several depths.
Scar filling with own fat works most reliably in small amounts spread through the tissue, because each strand of fat needs a blood supply to survive.
How much of the injected fat survives?
Some, but not all, and the amount varies. A 2017 systematic review in PRS Global Open reported long-term fat graft resorption of roughly 25 to 80 percent. We do not quote a clinic survival percentage, because it depends on the scar, the area and the person.
- Early swelling makes the scar look fuller than the final result for some weeks.
- Settling: part of the fat is absorbed over about three months.
- What remains after that usually stays stable.
Fat may also improve the scar itself. A 2017 review in Scars, Burns & Healing of 23 studies reported improvements in colour, thickness, volume, pain and function, though the authors noted the evidence was mostly from lower-level studies.
How long does fat grafting last for scars?
The fat that survives the first three months generally lasts, changing only with large weight change. In our practice, if a second session is needed, it is planned after [verified interval], once the first graft has settled.
When is excision or a local flap the better choice? Options for scar fat grafting in Rajkot
When the problem is mainly the scar's width or the skin, not missing volume. Fat transfer for scar revision cannot narrow a wide scar or replace damaged skin.
- Excision: a wide or stretched scar is cut out and closed in layers, giving a thinner line.
- Local flap: nearby healthy skin and fat are moved to fill a large defect or release a tight scar.
- Raised scars are different: thick or keloid scars need another approach, covered in Raised scar and keloid care.
Sometimes the plan combines both: excision or a flap first, then fat transfer later to smooth any remaining dip. Examples of scar work are on our Before and after results page.
What does recovery at the donor and scar sites involve?
Usually a short recovery, with most people back to desk work within a few days.
- Donor site: bruising and soreness like a small liposuction, with a compression garment for a few weeks.
- Scar site: swelling and bruising for one to two weeks; the area looks overfilled at first.
- Avoid pressure and massage on the treated scar for the first weeks, so the fat can take.
- Sun protection for the scar while it settles.
- Review: a check at about one week, then at three months to judge the result.
Next step
The quickest way to know whether a fat injection in depressed scar tissue will help is a photo review. Send scar photos taken in good light, from straight on and from the side, with a note on when and how the scar formed.
This page is for education and is not a substitute for examination. Fat survival figures are ranges reported in published reviews, and no clinic success rate is claimed. The selection table is a general guide; the plan for your scar is decided after examination. Please consult Dr. Ashutosh A Shah about your own treatment.
FAQs
Is fat transfer for scars permanent?
The fat that survives and gains a blood supply usually stays, so that part of the correction lasts. But some of the injected fat is always absorbed in the first few months, and how much varies from person to person. The result is judged after about three months, once that settling has finished.
How many sessions are needed for a deep scar?
Often one, sometimes two. A shallow or narrow depression may be corrected in one sitting, while a deep or firmly stuck scar often needs a second session once the first has settled. Overfilling in one sitting is avoided, because crowded fat survives less well.
Can fat injection help a burn scar?
It can help some burn scars, especially tight, thin or tender ones, by softening the tissue and easing tightness. A 2017 review reported improvements in thickness, colour, pain and function in scars including burns. Large burn contractures that limit movement usually need surgical release or grafting as well.
Is it done under local anaesthesia?
Small scars are often treated under local anaesthesia, with numbing at both the donor area and the scar. Larger areas, or treatment at several sites, may need sedation or general anaesthesia. For scar fat grafting in Rajkot or at the clinic, the choice depends on the size of the scar and your comfort.
Can fillers be used instead of fat?
For small, shallow scars on the face, a filler can lift the depression for some months without a harvest site. Fillers do not release tethering bands and need repeating. For larger or body scars, fat is usually preferred because it gives more volume and can improve the scar tissue itself.
How soon after an injury can a scar be treated?
Usually once the scar has matured, which often takes about 12 months, when it has turned pale and soft. Treating too early can be undone by ongoing scar remodelling. Earlier treatment may be considered if a scar is tethered to deeper tissue and limiting movement.
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