Subcision for Acne Scars? Done Fraxel Restore 3 Times and No Improvement. (photo)

I am 50 and have been having acne scars for 30 years. I recently had Fraxel re:store, 3 times , 6 weeks apart, and don't see the improvement. I bought a package of 4 times, so I'll have one more Fraxel re:store. My doctor recommended to have subcision after the 4th Fraxel. My question is: Should I have subcision after the 4th Fraxel or before? Or 4th Fraxel, subcision and another Fraxel? Should I consider other treatment like TCA cross, silicone injection?

Doctor Answers (1)

Subcision Works well for Depressed Acne Scars in conjunction with Laser Resurfacing


With the significant acne scarring present in these photos, I have found a three fold approach to be most beneficial. Before beginning any treatment, control outbreaks and clear up skin with oral and topical antibiotics and hormones if necessary.

First I have found subcision works well the day of the laser procedure.

Secondly I have found injecting filler (my favorite is your own Fat or Radiesse) to help raise the depressed area. In the case of Fat Grafting, there are also a number of Growth Factors and Stem Cells that will stimulate Collagenesis.

Thirdly I have found setting the Fractional laser (I prefer CO2 over 1540nm) on a small spot size to reduce the "Shoulders of the Scars", followed by a larger spot size over the entire face including the subcisioned site for best color and texture match.

There is some extra bruising and swelling with the healing time elongated to a week vs the 4 to 5 days we usually see with just Fractionsl CO2. We have also helped patients with the use of "Copper Cream" by Procyte as a topical to accelerate healing. Good Luck, M.Lyons,MD

Mobile Facial Plastic Surgeon
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