Would subcision help with deep boxcar scars on my temple? 25 year old male with type III skin. (photos)

Question

Hi, Here is my basic info: Gender: Male Age: 25 Skin Type: III (East Asian) I have some really deep boxcar scars on my temple area, and I have tried several sessions of CO2 Laser/RF microneedling/Non-ablative lasers, but I didn't really see any improvement. As you can see in the picture, the scars are depressed, I live around Seattle area, and I have a hard time finding an acne scar specialist who is able to perform subcision on my temple.. Will subcision/TCA help in this case? Thanks

Raffy Karamanoukian, MD, FACS · Answer

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best, Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Dr. Karamanoukian 
Realself100 Surgeon

Nelson Lee Novick, MD · Answer

The simple answer to your question is YES. Subcision, which involves breaking the tethering fibers that hold indented scars down and also stimulates new, native collagen and elastic fiber synthesis, is a simple, quick and inexpensive technque for elevating and smoothing all kinds of indented scars, including acne-related boxcar and rolling scars. I have been performing subcision with gratifying results since 1995. Had you been a regular follower of my answers, you would have known that I have been cautioning readers for many years to exercise a very healthy dose of buyer beware when considering expensive fraxel laser and RF treatments, as the claims for the benefits of these expensive "bells and whistles" (as you have unfortunately learned the hard and expensive way) are far more backed by device manufacturer and social media influencer hype than any hard science. Sorry. You would be wise to make sure this time to consult with an experienced cosmetic dermatologist. Best of luck.

David M. Kowalczyk, MD, MBA, FACS · Answer

Hi there! I often use subcision on deep, tethered scarring for good improvement. This will often be combined with Morpheus8 microneedling RF which can tone the skin. At times, I will use nanofat or PRP to provide stem cells and growth factors ideal for healing. It would likely require multiple treatments in your case being careful based on your skin tone. Although not ideal, sometimes excision of the areas which are least responsive can work well. Hope that helps!

James G. Wu, MD, FAAD · Answer

Based on your photos, I think nokor needle subcision is the perfect treatment for your scars. You may not need TCA cross. It's a shame that many people treat these type of scars with lasers and microneedling first when they would benefit most from subcision.

Would subcision help with deep boxcar scars on my temple? 25 year old male with type III skin. (photos)

Answers (4)

Answer: Yes

Answer: Yes

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Would subcision help with deep boxcar scars on my temple? 25 year old male with type III skin. (photos)

Answers (4)

Answer: Yes

Answer: Yes

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Everything you need to know about Subcision

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