Are my Scars Suitable for Subcision? (photo)

I'm convinced that subcision would be the best way to treat these scars. When I stretch my skin, the scars don't flatten. Can subcision still be preformed on both these scars since they're right next to each other? Also, I know that subcision is better paired with a filler or the 'subcision suction method'. Rather than subcision alone.

Doctor Answers 6

Subcision is a good start

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Subcision is an excellent start for your acne scarring.
It can be done alone, or a filler can be added.
In your case I would try simple subcision first and do subcision/filler second if needed.
Best wishes,
Dr. Denkler

Subcision alone/ with other treatments.

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Hi,
Subcision is a very good option for the depressed scars, and there should not be a problem with the scars being right next to each other. Suction after subcision helps to improve the results.
Fillers are not always required following subcision, but they definitely help to give better results quickly. 
Good luck!

Subcision for indented Acne Scars?

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Hi Andrew.  Yes, you are a candidate for subcision.  In this procedure, we use the needle of the Restylane syringe to release hard, fibrous scar tissue below the depression and then we injection the Restylane in the void created by releasing the scar tissue.  

While this will give you immediate benefits, the best results are when we perform the procedure every 6 - 9 months over a period of years.  This increases your chance of having collagen remodeling fill the scar from below.  

Take a look at the before and after photos at the link below and call us for a free consultation if you are in the Los Angeles area.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews

ACNE SCAR TREATMENT | DR DANIEL CHANG RECOMMENDS COMBINATION APPROACH

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Dear abc,

Thank you for your question. 

Acne scars are common, but with advancement in technology, thankfully it is not something you have to live with.

Acne scars are the result of the breakdown of collagen and elastin in your dermis. They frequently occur at sites which were acne prone in the past, namely your temples, cheeks etc.

You have atrophic rolling and boxscars so subcision is one of the modalities that would help. Combination treatment would give you the best results.

Acne scars are 3 dimensional, hence submitting a photo will not do justice to your scar. It requires real time examination (touch and animation), combined with lighting from various angles. That is why you may notice your scars differently in the bathroom mirror and in the dressing table mirror.

Dr Daniel Chang’s 3 STEP ACNE SCAR Treatment Formula: 

1- Control acne

2- Treatment – Fractional laser + skinboosters ( to promote collagen growth)

3- Maintainence with lasers ( to optimise collagen stimulation)

STEP 1: CONTROL YOUR ACNE. (Refer to this page on acne for more information)

Achieving good control of your acne is the important principle towards helping your acne prone skin. This prevents new scars from forming, which is a big step forward. Dont be too worried about your existing acne scars. Focus on prevention first.

STEP 2: Treatment based on scar type. Below are the 4 main types.of atrophic scars.

Ice pick scars =>    can be treated with TCA CROSS, Fractional and Microneedling

Rolling and box scars scars => are best treated with a combination of  RF Microneedling, PRP, fractional lasers and subcision

Hypertrophic scars can be treated with

  •  Microbotox
  • Intralesional steroid

Atrophic scars -> A combination approach is what I would recommend to improve the appearance of such scars.

  • Laser Resurfacing +/- RF microneedling 
  • Subcision
  • Dermal fillers – Skinboosters – Please refer to my Page on Skinboosters 
  • Intralesional saline – ( Latest evidence from Journal of Dermatology Sept 2016)

Fractional C02 used to be the industry gold standard for treatment of acne scars. Current studies point towards combination therapy, as I have outlined above. In addition, As collagen takes 3 months to grow, multicentre studies show one would require at least 4 sessions to see results. 1 session is unfortunately not enough.

I hope you find this helpful.

Daniel Chang, MBBS
Singapore Physician

Hello

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If you’re trying to make your acne scars better you need to have laser treatment, depending on how deep they are or what kind of scars you are dealing with. You have a few different options. There is Profractional laser, micro laser peel or even a face lift to stretch the skin and help improve the deeper scars. Good luck..

 

Stuart B. Kincaid, MD, FACS (in memoriam)
Beverly Hills Plastic Surgeon

Subcision for Acne Scars

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Subcision works best for 'rolled' depressions or 'rolled' scars (as opposed to 'ice pick'  or 'box car' scars). The technique involves inserting a special needle just under the skin to break up the scar tissue and bands that pull down the skin create these depressed scars. Looking at you pictures, I think you could benefit from a subcision procedure. You are also correct in that a phsyician will often place filler under the scars after subcision to lift them up, after the bands are severed. As well, usuing a suction device overtop of the skin after subcision also helps lift up the depressions. Subcision is associated with bruising and therefore has some downtime. As with any scar treatment, you will see significant improvement but 100% resolution of scarring is hard to acheive. Often to obtain maximum results, combination therapy with other resurfacing treatments is needed.

Adam J. Mamelak, MD
Austin Dermatologic Surgeon

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.