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Had filler for acne scars- Please Help

I had juvederm done in some rolling acne scars on my cheeks 8 days ago. For three days the scars looked completely GONE. Since then, they have been coming back. Overall, there is an increase in volume but no difference to scars. My dr is convinced that I need more product but I think it was a technique issue. I can understand being a little "deflated" after swelling goes but not for scars to return! Is it possible to get the remaining portions subcised and THEN reinjected with more product?

Doctor Answers (8)

Acne scar treatment

+3
Fillers are one option for treating acne scars but in my opinion they are no longer the gold standard to treat acne scars. The results are temporary as the filler product gets broken down over time. Lasers and other devices, particularly the fractionated lasers (which were invented by Harvard dermatologists), are currently the best way to improve these lesions in my opinion. I would recommend seeing a physician with advanced training in laser surgery. Understanding how these lasers work, can give you safer and better results.


Stamford Dermatologic Surgeon
5.0 out of 5 stars 8 reviews

Fillers for acne scars

+2
There are many other treatments now available for acne scars.  One of my preferred treatments is Sculptra, a collagen stimulator, which when injected under the skin causes your body to form collagen in the areas of the scars and gives a permanent improvement.  Sometimes several treatments are needed and sometimes these treatments can be combined with Fractionated laser or Ultherapy for further improvement. One exciting new technology for treatment is Thermi RF tight and smooth which are approved for skin and soft tissue tightening but also work by stimulating the body's own collagen and might be helpful depending on the area of acne scarring.

Joseph A. Eviatar, MD, FACS
New York Oculoplastic Surgeon
5.0 out of 5 stars 25 reviews

Subcision Followed By A Volumizing Filler Is An Excellent Approach To Acne Scar Treatment

+2
If you check out the archived of Realself, you will find that I have written extensively on the subject of the combined treatment of acne scars using first subcision followed immediately by the injection of a biostimulatory filler.

The subscision breaks up the downwardly pulling tethering bands of scar tissue--allowing the base of the scar to float upward. Even more importantly, it facilitates new native collagen synthesis to occur over the next several weeks to replace the treatment fractured scar collagen. The subsequent introduction of a biostimulatory filler, such as Radiesse combined with Perlane L in my Upper East Side Manhattan office (or Radiesse plus Restylane SQ in my Israel satellite office where the latter is regulatory agency approved) promotes additional neocollagenesis within the next several weeks and at the same time provides an immediate lift to the base of the scar yielding a gratifying on-the-spot improvement. 

Nelson Lee Novick, MD
New York Dermatologic Surgeon
5.0 out of 5 stars 11 reviews

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Fillers used for acne scars

+2
One would need to know which filler substance was used. There are several categories of filler substances that can be used for acne scarring. Some swell immediately with injection and therefore, there is caution with the amount of substance that is injected due to the potential of overfilling. Overall, those type of fillers are temporary. There are collagen stimulating fillers that work in different manner. For this reason, they are my preferred filler substances when treating acne scars.

Cheryl M. Burgess, MD
Washington Dermatologic Surgeon

Acne scars

+2
When filler is put in, there is some subcision that occurs from the needle or canula.  Sometimes this is enough to help free up the scar tissue so that the filler can keep it elevated.   If your scarring is deep or you had some large scars, a more aggressive subcision is often indicated.  There are many lasers, for ex. the 1540nm laser from Palomar) which can also help to free up the scars and help to produce some new collagen under the skin.  Fat is also a good choice since it is long lasting and has stem cells which can help to improve the skin quality.      

John J. Martin, Jr., MD
Coral Gables Oculoplastic Surgeon
5.0 out of 5 stars 7 reviews

Acne scarring treatment-filler-laser

+2
Thank you for that excellent question.  Unfortunately scarring from acne is very common.

And treatment is difficult.

I always tell my patients that we can likely improve this fine but it is difficult to eliminate it.

A combination of fillers, chemical peels, and various lasers can be used to improve the appearance.

I hope that helps.

Dr.  Daniel Radin. Dermatologist,  Windsor, Ontario,Canada

Daniel Radin, MD
Windsor Dermatologist

Acne scar treatment

+2
Yes, it is possible to subcise the scars and then fill. In my office, I prefer to subcise and wait about 90 days before treating the remaining area with filler. The subcision itself will result in improvement to the scar, sometimes dramatically. Acne scars, in my opinion, always do better with multi-modality treatment, using a combination of subcision, filler, lasers or chemical peels. 

Lee P. Laris, DO
Phoenix Dermatologist
5.0 out of 5 stars 11 reviews

... this can happen, and that's why I warn patients

+1
.... your problem is not uncommon. Sometimes we need to take fillers in steps, much like building blocks. For example, if you lack volume, a thick filler like Juvederm Voluma can help, this lifts your acne scars from underneath. If you have superficial scars, then using a more fluid filler such as Juvederm Volbella can be excellent. Layering and not going overboard is the key.

For scars, its much harder technique than just volume. Don t be disheartened if you need several treatments to achieve improvement. 

regards

Dr Davin Lim 
Cosmetic and Laser Dermatologist
BRISBANE   AUSTRALIA

Davin Lim, MBBS, FACD
Brisbane Dermatologist
5.0 out of 5 stars 4 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.