How soon after Ultherapy can I get Subcision/PRP/Microneedling? (Photo)

Question

I am having monthly appointments of Subcision/PRP/Microneedling to help pitted acne scars on my cheeks. I want to get full face Ultherapy to lift and tighten my skin. Is it okay to have my Subcision/PRP/Microneedling appointment 1 week after Ultherapy ? Also, will Ultherapy be a bonus help for depressed acne scars where there has been a substantial loss of collagen?

Douglas Wu, MD · Answer

One week between procedures should be just fine. Ultherapy uses ultrasound energy to constrict tissue and stimulate collagen production. The additional boost may help to improve your scars, as well as the overall appearance of the skin. Always choose an experienced, board-certified dermatologist for these procedures to ensure an optimal outcome.

Jason Emer, MD · Answer

we do Ultherapy at the same time as the microneedling, subcision and fillers. Please see an expert they should've been able to guide you if they are experienced.  Best, Dr. Emer.

Davin Lim, MBBS, FACD - Account Suspended · Answer

Ultherapy has been reported for scars, as has a combination of Radiese and HIFU. To answer your question on subcision post Ultherapy, the answer is YES, there are no contraindications. 
The ideal treatment for acne scars will depend on the morphology of individual scars. For example, rolling scars are best treated with subcision, atrophic scars with fillers, pick-ice pick scars with TCA or Phenol CROSS/ Paint, box-scar scars with fractional laser/ modified TCA/ phenol chemical peels, hypertrophic scars with steroid injections/modulated fractional delivery.

Energy devices such as lasers, microneedling RF and bipolar radiofrequency are other methods to treat ‘general’ scar types. For example devices can improve rolling-tethered scars as well as ‘deep - superficial scars’ such as broad ice-pick scars and broad box-car scars. Devices should be viewed as a method of scar revision, and rarely as a sole modality. Exceptions do apply- for example in patients with predominantly shallow/broad box-car scars and or superficial pits.

Another factor that will determine the ideal combination of treatment is the skin type of patients. Skin typing used to determine the ‘skin colour’ of patients. Darker skin patients will require modifications to treatment parameters. This includes a lower percentage of chemical peels, conservative protocols for lasers and energy devices and in some cases pre and post treatment of skin to reduce but not eliminate the chances of PIH- post inflammatory hyperpigmentation- skin darkening.

The very first step in scar revision is to accurately determine the subset of scars you have. This is best done with a real time examination. Factors such as animation (rather than static photographs) are frequently used to determine the amount of ‘deep scarring’ /anchored scars or tethering. Palpation or touch is also extremely important to determine the presence of dermal and subdermal fibrosis. Scars that have altered ‘texture’ either hard or soft (atrophy) are more challenging to treat compared to scars with ‘normal’ texture. In some cases the use of angled lighting can be employed to accurately map scar types.

My answers given in the context of this question is a general plan given the limited information. For an accurate guide, one has to take into consideration factors such as animation, touch, feel, real time examination and most importantly subjective measures, namely patient expectations. A real time consult with a procedural dermatologist or plastic surgeon is required for the best accuracy- diagnosis.

All the best, Dr Davin S. Lim, Dermatologist. Brisbane. Australia.

How soon after Ultherapy can I get Subcision/PRP/Microneedling? (Photo)

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How soon after Ultherapy can I get Subcision/PRP/Microneedling? (Photo)

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Everything you need to know about Subcision

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