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Larger Indent After Juvederm Ultra and Cortisone
Cortisone injections can make a depressed scar look worse before it gets better. Steroids like triamcinolone thin and atrophy the surrounding fat and collagen, so if the cortisone diffused beyond the scar tissue itself, it can hollow out normal tissue next to it, and any Juvederm in that area may have broken down faster than expected, possibly due to how steroids affect the surrounding tissue environment. That combination can make an indent look larger than it did originally. The underlying issue is usually that the scar is tethered, meaning bands of fibrous tissue pull the skin down to deeper layers. Filler alone often can't fill that space because it can't get past the tethering to lift the skin back up. These cases usually need subcision or scar release to free those bands before refilling, sometimes with filler, sometimes with fat grafting. See a board-certified plastic surgeon in person so they can assess how much of the change is atrophy versus tethering versus filler loss, and map out next steps.
Clinical Context
Filler results near scars can be unpredictable because scar tissue itself is still changing weeks to months after healing. As collagen matures, it can tighten and pull skin toward deeper layers, which is different from filler simply dissolving. This is why an area can look fine initially, then appear more indented later without new trauma. Because both steroids and filler interact with tissue that hasn't fully stabilized, results in these zones are harder to predict than in unscarred skin, and follow-up evaluation is often needed to sort out the cause.
