Will microneedling break down superficial filler that was used to treat acne scarring?

Question

I have rolling acne scars and two months ago had them filled with belotero. I’ve had it done before with nice results but this time I have visible small bumps in many areas. I’ve scheduled a microneedling appt to address the scars and am wondering if it will break down the filler. I’m kind of hoping it will.

Jason Emer, MD · Answer

No, we often combined these treatments on the same day to improve acne scarring. Keep in mind, acne scars need a combination approach for improvement.  For the best results, one should target the acne scar type.  As everyone has a unique pattern of acne scarring, the best solution is a tailored one.  Typically you need fillers like bellafill and sculptra for atrophic indented type scars with or without subcision.  Subcision for depressed tethered scars.  Vascular lasers like yellow laser, aerolase, excel V or IPL for redness or thick scars. And lasers such as fraxel, erbium, co2 or fractional radiofrequency like venus viva, skinfinity, intensif microneedling RF for textural issues and superficial scarring.  Deep ice pick scars and narrow box car scars are best treated with TCA CROSS and punch excision.  All lasers are combined with microneedling and PRP to get even better results and improve healing times.   The majority of patients will have a collection of different scar types, and hence a tailored treatment plan is needed by an expert physician.  It is never about the laser or product that gives the results, its about the expert behind the equipment that gets you the outcome.  Scars cannot be cured and will need life-long treatments to maintain and build on the results.  Best, Dr. Emer.

Shaun Patel, MD · Answer

Microneedling should not interfere with underlying filler. However, if I have had the choice, I would perform a series of microneedling treatments prior to performing filler for acne scars.

Aurora DeJuliis, MD · Answer

Microneedling when performed with the patient's own PRP is a great treatment for acne scars, fine lines, and overall collagen stimulation. In your particular case it is difficult to make an assessment because you need to consult with an experienced physician. If the bumps are so superficial microneedling could help to accelerate the break down of the filler, but you could also consider having the bumps dissolved by the physician that injected your scars.

Neda Vanden Bosch, MD · Answer

No, Microneedling will not break down fillers used to correct acne scarring. We usually wait 2 weeks between treatments though. We commonly use multiple modalities to conquer different issues to give the best results. We devise a individual treatment plan for every patient based on their needs, combining Fillers, Lasers, Botox and Microneedling.

Davin Lim, MBBS, FACD - Account Suspended · Answer

The definitive answer is no. We published this in a research article to confirm studies in humans under biopsy control. In fact even with RF microneedling, fillers were still present. As for acne scars, far more effective procedures than micro needling.

Acne scar revision comprises of many specialised procedures. For the best results, one should target the acne scar type with appropriate treatments METHODS. Using one or two devices is not optimal. As everyone has a unique pattern of acne scarring, the best solution is a tailored one. Remember, scar revision is a medical procedure that is technical to perform. It is not dependent on the clinic, branch, machine, or laser but by the skill of your dermatologist of plastic surgeon.

Take for example deep ice pick scars, and narrow box car scars. These are best treated with TCA CROSS and focused angled Co2 fractional laser in low density. Deep narrow scars respond better to this treatment than even the most expensive lasers. On the flip side, rolling, and atrophic acne scars can improve with fractional devices such as Fraxel, fractional lasers, ProFractional erbium lasers, Infiini –Intensif –Intracel radiofrequency microneedling. Atrophic scars (depressions) can be treated with either fat graft, PRP or dermal fillers. Tethered and anchored scars are best treated with surgical techniques such as subcision. Other surgical techniques that I use include punch elevation, surgical elevation, punch excision and traditional excision for focal scars. Early and very mild acne scars respond well to eMatrix and non-energy microneedling, as well as vascular lasers. Skin colour changes such as PIH or dark marks respond best to sun protection, creams, and Q switch lasers in the nano and pico pulse durations.

In the vast majority of patients, different patterns of acne scars will be present. Monomorphic acne scarring (scars of the safe subtype) are extremely rare. Careful examination, especially under angled lighting with scar mapping will give you an understanding of what are the best options for your scars. Additionally tactile examination namely touch will give me an understanding of the amount of subdermal fibrosis, as special equipment is needed for this sub-set of acne scars.  In the majority of patients its finding the correct combinations that yields the best results. It is never about the device, it is about the specialist behind the equipment that will deliver the best outcomes.

Global leaders in acne scar revision will always use manual methods to revise scars, and employ lasers and energy devices as instruments to assist. All the best, Dr Davin Lim. Acne scar dermatologist specialist. Brisbane, Australia.

Will microneedling break down superficial filler that was used to treat acne scarring?

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